ABSTRACT
No disponible
Subject(s)
Humans , Catheterization, Central Venous/adverse effects , Phrenic Nerve/injuries , Critical Care , Risk Factors , Diagnosis, DifferentialSubject(s)
Catheterization, Central Venous/adverse effects , Peripheral Nervous System Diseases/etiology , Phrenic Nerve , Adolescent , Adult , Aged , Aged, 80 and over , Catheterization, Central Venous/methods , Female , Humans , Intensive Care Units , Male , Middle Aged , Peripheral Nervous System Diseases/diagnosis , Peripheral Nervous System Diseases/epidemiology , Prognosis , Prospective Studies , Young AdultABSTRACT
Fundamento y objetivo: La valoración de los enfermos tras un paro cardiorrespiratorio (PCR) es importante para la toma de decisiones sobre la limitación del esfuerzo terapéutico. El estudio buscó factores pronósticos en los pacientes tras un PCR recuperado. Material y método: Estudio retrospectivo de enfermos en coma tras un PCR. Se analizaron la edad, el sexo, el Glasgow Score Coma (GCS), los reflejos pupilares, las variables relacionadas con el PCR (causa, duración, presenciado o no presenciado), el estatus mioclónico y los patrones del electroencefalograma (EEG): mal pronóstico, pronóstico incierto y benigno. Resultados: Se estudiaron 50 enfermos. Las variables asociadas con mortalidad fueron la ausencia de reflejos pupilares (riesgo relativo [RR] 0,277, intervalo de confianza del 95% [IC 95%] 0,103-0,741, p = 0,01), el GCS bajo (RR 0,701, IC 95% 0,542-0,908, p = 0,007) y el estatus mioclónico (RR 0,38, IC 95% 0,176-0,854, p = 0,01). En 22 pacientes se analizaron los patrones del EEG, sin apreciarse significación estadística. Conclusiones: La ausencia de reflejos pupilares, la baja puntuación del GCS y el estatus mioclónico son factores de mal pronóstico en pacientes tras un PCR. Los patrones del EEG mostraron una tendencia no significativa de asociación con el pronóstico (AU)
Background and objective: Predictors of unfavorable outcome in patients after cardiopulmonary arrest (CPA) are important to make decisions about the limitation of therapeutic efforts. The aim was to analyze the clinical variables in the prognosis of patients recovered after CPA. Material and method: Retrospective study on comatose patients with recovered CPA. The variables were: age, sex, Glasgow Coma Score (GCS), pupillary light reflex, other variables related to CPA (cause, duration, witnessed or not witnessed), myoclonic status and electroencephalographic (EEG) patterns. Results: Fifty patients were studied. The variables associated with mortality were the absence of pupillary light reflex (hazard ratio [HR] 0.277, 95% confidence interval [95% CI] 0.103-0.741, P = .01), a low GCS (HR 0.701, 95% CI 0.542-0.908, P = .007) and myoclonic state (HR 0.38, 95% CI 0.176-0.854, P = .01). We evaluated the EEG patterns in 22 patients. No statistical significance was observed. Conclusions: The absence of pupillary light reflex, a low GCS and myoclonic state are prognostic factors in patients recovered after a CPA. The EEG patterns showed a nonsignificant association with prognosis (AU)
Subject(s)
Humans , Heart Arrest/epidemiology , Electrocardiography/methods , Hypoxia/physiopathology , Prognosis , Retrospective Studies , Coma/physiopathology , Mortality/statistics & numerical data , Epilepsies, Myoclonic/complications , Risk FactorsABSTRACT
BACKGROUND AND OBJECTIVE: Predictors of unfavorable outcome in patients after cardiopulmonary arrest (CPA) are important to make decisions about the limitation of therapeutic efforts. The aim was to analyze the clinical variables in the prognosis of patients recovered after CPA. MATERIAL AND METHOD: Retrospective study on comatose patients with recovered CPA. The variables were: age, sex, Glasgow Coma Score (GCS), pupillary light reflex, other variables related to CPA (cause, duration, witnessed or not witnessed), myoclonic status and electroencephalographic (EEG) patterns. RESULTS: Fifty patients were studied. The variables associated with mortality were the absence of pupillary light reflex (hazard ratio [HR] 0.277, 95% confidence interval [95% CI] 0.103-0.741, P=.01), a low GCS (HR 0.701, 95% CI 0.542-0.908, P=.007) and myoclonic state (HR 0.38, 95% CI 0.176-0.854, P=.01). We evaluated the EEG patterns in 22 patients. No statistical significance was observed. CONCLUSIONS: The absence of pupillary light reflex, a low GCS and myoclonic state are prognostic factors in patients recovered after a CPA. The EEG patterns showed a nonsignificant association with prognosis.
Subject(s)
Electroencephalography , Heart Arrest/physiopathology , Adolescent , Adult , Aged , Aged, 80 and over , Electroencephalography/methods , Female , Humans , Male , Middle Aged , Prognosis , Retrospective Studies , Video Recording , Young AdultABSTRACT
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