[Early outcome assessment following heart arrest is currently impossible. Clinical parameters are easy to use but afflicted with uncertainty].
A critical review of a meta-analysis published in JAMA of early clinical neurological signs to detect "good" or "bad" outcome after cardiac arrest is presented. The review focuses on weaknesses of Glasgow Coma Scale, the Glasgow-Pittsburgh Cerebral Performance Categories (CPC) and on individual differences in factors after arrest for study inclusion. It is suggested that the clinical assessments should be complemented with the assessment of neurochemical markers for brain damage.
Starmark
Jan-Erik
JE
Neurologiska kliniken, Sahlgrenska Universitetssjukhuset, Göteborg, Sweden. jan-erik.starmark@neuro.gu.se
D015415:Biomarkers / Q000097:blood / Q000134:cerebrospinal fluid; D001925:Brain Damage, Chronic / Q000175:diagnosis / Q000209:etiology; D003128:Coma / Q000175:diagnosis / Q000209:etiology; D015600:Glasgow Coma Scale; D023261:Glasgow Outcome Scale; D006323:Heart Arrest / Q000150:complications / Q000175:diagnosis* / Q000401:mortality; D006801:Humans; D009460:Neurologic Examination; D017063:Outcome Assessment, Health Care; D011379:Prognosis; D020127:Recovery of Function; D012680:Sensitivity and Specificity
D015415:Biomarkers