Complete neurologic recovery key to long-term survival after cardiac arrest

Cardiac arrest survivors who achieve complete neurologic recovery are more likely to have better long-term survival outcomes than those with persistent neurological disabilities, according to a study.

Researchers used data from four mandatory national registers with structured and predefined data collection and nationwide coverage during a 10-year period in Sweden. They looked at 9,390 adults (median age 69 .0 years, 69.7 percent male) who survived in-hospital cardiac arrest (IHCA) or out-of-hospital cardiac arrest (OHCA) beyond 30 days.

All participants underwent neurologic assessment (ie, the Cerebral Performance Category [CPC] scale) at hospital discharge. Patients were grouped into three categories based on the result of the assessment: complete recovery (CPC 1), moderate disabilities (CPC 2), and severe disabilities (CPC 3-4).

Of the participants, 7,374 (78.5 percent) had CPC 1, 1,358 (14.5 percent) had CPC 2, and 658 (7.0 percent) had CPC 3 or 4. The 5-year survival rate was 73.8 percent (95 percent confidence interval [CI], 72.5–75.0) in the CPC 1 group, 64.7 percent (95 percent CI, 62.4–67.0) in the CPC 2 group, and 54.2 percent (95 percent CI, 50.6–57.8) in the CPC 3 or 4 group.

The risk of death was significantly higher in the CPC 2 group (adjusted hazard ratio [aHR], 1.57, 95 percent CI, 1.40–1.75) and the CPC 3 or 4 group (aHR, 2.46, 95 percent CI, 2.13–2.85) compared with the CPC 1 group. Similar associations were seen in the OHCA and IHCA subgroups.