ArticleJournal of neurology, neurosurgery, and psychiatry1996
Early prognosis in coma after cardiac arrest: a prospective clinical, electrophysiological, and biochemical study of 60 patients.
Article in Journal of neurology, neurosurgery, and psychiatry, 1996. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 35 papers, 5 of them syntheses that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
35 citing papers in PubMed, 5 syntheses or guidelines pooled it, 215 citations in OpenAlex.
- Part 8: Post-Cardiac Arrest Care: 2015 American Heart Association Guidelines Update for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care.Circulation · 2015Guideline
- Recommendations on the use of EEG monitoring in critically ill patients: consensus statement from the neurointensive care section of the ESICM.Intensive care medicine · 2013Guideline
- S-100B and neuron-specific enolase as predictors of neurological outcome in patients after cardiac arrest and return of spontaneous circulation: a systematic review.Critical care (London, England) · 2009Pooled it
- Early prediction of individual outcome following cardiopulmonary resuscitation: systematic review.Emergency medicine journal : EMJ · 2005Pooled it
- Are somatosensory evoked potentials the best predictor of outcome after severe brain injury? A systematic review.Intensive care medicine · 2005Pooled it
- Electroencephalography (EEG) for neurological prognostication after cardiac arrest and targeted temperature management; rationale and study design.BMC neurology · 2014Trial
- Review
- Predicting neurological outcome after cardiac arrest by combining computational parameters extracted from standard and deviant responses from auditory evoked potentials.Frontiers in neuroscience · 2023Article
- Blood-brain barrier disruption as a cause of various serum neuron-specific enolase cut-off values for neurological prognosis in cardiac arrest patients.Scientific reports · 2022Article
- Article
- Amplitude-Integrated Electroencephalography and Brain Oxygenation for Postcardiac Arrest Patients with Targeted Temperature Management.Therapeutic hypothermia and temperature management · 2019Article
- Article
- Quantitative EEG Metrics Differ Between Outcome Groups and Change Over the First 72 h in Comatose Cardiac Arrest Patients.Neurocritical care · 2018Observational
- Targeted Temperature Management and Multimodality Monitoring of Comatose Patients After Cardiac Arrest.Frontiers in neurology · 2018Review
- Occurrence of overt seizures in comatose survivor patients treated with targeted temperature.Brain and behavior · 2017Article
- The Reemergence of EEG Reactivity After Cardiac Arrest.The Neurohospitalist · 2017Article
- Global cerebral ischemia due to circulatory arrest: insights into cellular pathophysiology and diagnostic modalities.Molecular and cellular biochemistry · 2017Review
- Multi-Center Study of Diffusion-Weighted Imaging in Coma After Cardiac Arrest.Neurocritical care · 2016Observational
- Electrophysiologic monitoring in acute brain injury.Neurocritical care · 2014Review
- How to assess prognosis after cardiac arrest and therapeutic hypothermia.Critical care (London, England) · 2014Review
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
4 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundThe univariate study of clinical, electrophysiological, or biochemical variables has been shown to predict the outcome in postanoxic coma in about 50% of patients for each type of variable. Previous studies did not, however, consider the prognostic accuracy of a multivariate approach.
methodsSixty patients in coma for more than six hours after cardiac arrest were prospectively examined by means of repeated clinical examinations (including Glasgow coma score (GCS)), EEG, and medianus nerve somatosensory evoked potentials (SEPs). In 16 patients, the early concentrations of serum neuron specific enolase and ionised calcium were also measured.
resultsWithin the first year after cardiac arrest, 20% of patients made a good neurological recovery; 80% remained in a vegetative state or died. Clinical examination correctly predicted outcome in 58% of patients, SEP in 59%, and EEG in 41%. The combination of clinical examination, SEP, and EEG raised the percentage of correct predictions to 82%, without false pessimistic predictions. Concentrations of serum neuron specific enolase and ionised calcium were of no additional prognostic help. Multivariate regression analysis identified the association of GCS < 8 at 48 hours with abnormal or absent early cortical SEPs as highly predictive of a bad outcome (risk = 97%, 95% confidence interval = 86-99%).
conclusionThe combination of GCS at 48 hours, SEP, and if these are non-conclusive, EEG, permits a more reliable prediction of outcome in postanoxic coma than clinical examination alone.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.