Table 1.
Baseline demographic data and arrest characteristics.
| Characteristics | Cohort (n = 106) | Good Neurological Outcome (n = 45) |
Poor Neurological Outcome (n = 61) | p-Value |
|---|---|---|---|---|
| Age, years, median (IQR) | 57.0 (41.0–69.0) | 57.0 (42.0–68.0) | 57.0 (40.5–76.8) | 0.773 |
| Male gender, n (%) | 78 (73.6) | 37 (82.2) | 41 (67.2) | 0.193 |
| Comorbidities, n (%) | 0.544 | |||
| Coronary artery disease | 23 (21.7) | 11 (24.4) | 12 (19.7) | |
| Arrhythmia | 15 (14.2) | 5 (11.1) | 10 (16.4) | |
| Atrial fibrillation | 12 (11.3) | 3 (6.7) | 9 (14.8) | |
| WPW syndrome | 1 (0.9) | 1 (2.2) | 0 (0) | |
| VPC | 1 (0.9) | 0 (0) | 1 (1.6) | |
| 1st degree AV block | 1 (0.9) | 1 (2.2) | 0 (0) | |
| Cardiomyopathy | 2 (1.9) | 1 (2.2) | 1 (1.6) | |
| Hypertrophic cardiomyopathy | 2 (19) | 1 (2.2) | 1 (1.6) | |
| Heart failure | 7 (6.6) | 3 (6.7) | 4 (6.6) | |
| Etiology of cardiac arrest, n (%) | 0.863 | |||
| Acute coronary syndrome | 25 (23.6) | 12 (26.7) | 13 (21.3) | |
| Arrythmia | 16 (15.1) | 6 (13.3) | 10 (16.4) | |
| Hypoxia | 48 (45.3) | 21 (46.7) | 27 (44.3) | |
| Hyperkalemia | 4 (3.8) | 2 (4.4) | 2 (3.3) | |
| Metabolic acidosis | 2 (1.9) | 2 (4.4) | 2 (3.3) | |
| Anaphylaxis | 1 (0.9) | 1 (2.2) | 0 (0) | |
| Pulmonary thromboembolism | 1 (0.9) | 0 (0) | 1 (1.6) | |
| Unknown | 9 (8.5) | 3 (6.7) | 6 (9.8) | |
| Arrest characteristics | ||||
| Witness, n (%), | 69 (63.9) | 36 (80) | 33 (53.2) | 0.004 |
| Location of arrest, public place, n (%) | 29 (26.9) | 13 (28.9) | 15 (24.2) | 0.586 |
| Bystander CPR, n (%) | 77 (71.3) | 39 (86.7) | 38 (61.3) | 0.004 |
| Shockable rhythm, n (%) | 30 (27.8) | 24 (53.3) | 5 (8.1) | <0.001 |
| No flow time, min, median (IQR) | 2.0 (0–13.0) | 0.0 (0.0–5.0) | 5.0 (0.0–22.0) | 0.02 |
| Low flow time, min, median (IQR) | 20.0 (6.4–33.0) | 15.0 (8.0–20.0) | 29.0 (19.0–43.8) | <0.001 |
| Epinephrine dose administered during CPR, mg, median (IQR) | 2 (0–4) | 0 (0–2) | 3 (1.5–5) | <0.001 |
| Laboratory parameters | ||||
| pH, median (IQR) | 7.16 (7.00–7.32) | 7.27 (7.08–7.35) | 7.10 (6.97–7.30) | 0.024 |
| Lactate, mmol L−1, median (IQR) | 7.75 (4.73–11.33) | 7.70 (4.00–11.00) | 7.80 (4.90–12.00) | 0.050 |
| Albumin, g dL−1, median (IQR) | 3.3 (2.9–3.6) | 3.4 (3.2–3.6) | 3.2 (2.9–3.6) | 0.015 |
| Creatinine, mg dL−1, median (IQR) | 1.26 (0.95–2.55) | 1.26 (0.95–1.84) | 1.27 (0.94–2.91) | 0.350 |
| NGAL, ng mL−1, median (IQR) | 231.1 (100.8–677.7) | 155.4 (78.3–451.6) | 265.0 (130.7–683.0) | 0.002 |
| NSE, ng mL−1, median (IQR) | ||||
| Day 0 | 30.8 (23.3–58.0) | 24.0 (18.0–30.1) | 50.4 (29.4–73.3) | <0.001 |
| Day 1 | 39.8 (24.3–116.0), 95 * | 26.9 (20.6–35.8),40 * | 82.6 (33.7–277), 55 * | <0.001 |
| Day 2 | 35.1 (21.4–121.3), 88 * | 22.4 (16.4–24.5), 39 * | 97.2 (42.3–296.5), 49 * | <0.001 |
| Day 3 | 36.6 (17.6–144.0), 83 * | 18.3 (14.0–28.3), 38 * | 113.4 (37.2–276.0), 45 * | <0.001 |
| CK-MB, ng mL−1, median (IQR) | 5.6 (2.6–9.8) | 4.8 (1.9–8.4) | 6.6 (3.4–12.0) | 0.037 |
| Troponin I, ng mL−1, median (IQR) | 0.55 (0.06–52.8) | 0.17 (0.03–34.6) | 1.77 (0.10–273.00) | 0.131 |
| White blood cell, 103 u L−1, median (IQR) | 12.8 (8.8–17.6) | 12.8 (8.7–17.4) | 12.8 (8.8–18.7) | 0.625 |
| C-reactive protein, mg L−1, median (IQR) | 0.6 (0.5–0.7) | 0.5 (0.5–0.6) | 0.6 (0.5–0.9) | 0.249 |
| Procalcitonin, ng mL−1, median (IQR) | 0.22 (0.05–0.56) | 0.05 (0.05–0.22) | 0.30 (0.06–2.05) | 0.003 |
| Interleukin-6, pg mL−1, median (IQR) | 411.8 (017.4–2012.5) | 205.5 (57.8–513.6) | 595.0 (129.8–5000.0) | 0.013 |
| TWA–PaCO2, mmHg, median (IQR) | 38.8 (33.5–45.7) | 41.4 (34.2–47.3) | 37.9 (33.5–45.7) | 0.334 |
| ROSC to induction time at 33 °C, min (IQR) | 357 (0.0-1140.0) | 350.0 (120.0-767.0) | 358.0 (0.0-1140.0) | 0.680 |
| Received intervention prior to TTM, n (%) | ||||
| Coronary angiography | 31 (29.2) | 12 (26.7) | 19 (31.1) | 0.670 |
| Percutaneous coronary intervention | 13 (12.3) | 7 (15.6) | 6 (9.8) | 0.551 |
| Brain image | ||||
| ROSC to CT time, min (IQR) | 76.0 (41.0–117.0), 105 * | 67.0 (35.0–93.0), 45 * | 84.5 (49.8–134.3), 60 * | 0.129 |
| ROSC to MRI time, min (IQR) | 156.0 (111.5–227.5), 89 * | 131.0 (100.0–200.0), 37 * | 165.0 (120.3–240.3), 52 * | 0.294 |
| GWR of CT, median (IQR) | 1.21(1.11–1.29), 105 * | 1.25 (1.20–1.31), 45 * | 1.14 (1.06–1.24), 60 * | <0.001 |
| HSI on DWI, number (%) | 36 (33.3), 89 * | 0 (0), 37 * | 36 (69.2), 52 * | <0.001 |
| PV 400 ** of ADC, median (IQR) | 2.29 (0.32–4.18), 89* | 0.38 (1.18–2.89), 37 * | 3.41 (1.20–16.46), 52 * | <0.001 |
| CA-specific risk score | ||||
| OHCA score | 35.1 (23.4–56.0) | 23.5 (16.9–29.3) | 52.7 (38.0–61.2) | <0.001 |
| CAHP score | 181.0 (130.5–231.5) | 130.5 (103.4–156.6) | 217.5 (191.0–266.5) | <0.001 |
| C-GRApH score | 2.0 (2.0–3.0) | 2.0 (1.0–3.0) | 3.0 (2.0–3.0) | <0.001 |
IQR, interquartile range; WPW, Wolff–Parkinson–White; VPC, ventricular premature complexes; CPR, cardiopulmonary resuscitation; NGAL, neutrophil gelatinase associated lipocalin; NSE, neuron-specific enolase; TWA, time-weighted average; ROSC, return of spontaneous circulation; CT, computed tomography; MRI, magnetic resonance imaging; GWR, grey/white matter ratio; HSI, high signal intensity; DWI, diffusion-weighted image; PV, percentage of voxel; ADC, apparent diffusion coefficient; CA, cardiac arrest; OHCA, out-of-hospital cardiac arrest; CAHP, cardiac arrest hospital prognosis. * Number of patients included in the analysis; ** percentage of voxels below 400 × 10−6 mm2/s.