Neurological and functional status following cardiac arrest: method and tool utility.
BACKGROUND
Assessing the neurological and disability status of cardiac arrest (CA) survivors is important for evaluating the outcomes of resuscitation interventions. The Cerebral Performance Category (CPC)--the standard outcome measurement after CA--has been criticized for its poorly defined, subjective criteria, lack of information regarding its psychometric properties, and poor relationships with long-term measures of disability and quality of life (QOL). This study examined the relationships among the CPC and measures of global disability and QOL at discharge from the hospital and at 1 month after CA.


METHODS
Twenty-one CA survivors participated in the study. A medical chart review was conducted at the time of discharge to determine CPC and Modified Rankin Scale (mRS) scores, while 1-month in-person interview was conducted to collect mRS and Health Utilities Index Mark 3 (HUI3) scores. Data collected during the interview were used to determine follow-up CPC scores.


RESULTS
The strength of relationships among measures at discharge and 1 month ranged between fair to good. An examination of scatter plots revealed substantial variability and a wide distribution of chart review and 1-month mRS and HUI3 scores within each CPC category. CPC scores obtained through chart review were significantly better than the CPC 1-month scores, thus overestimating the participants' cognitive and disability status 1 month later.


CONCLUSIONS
When compared to disability and quality of life measures, it is apparent that the CPC has limited ability to discriminate between mild and moderate brain injury. The validity of using the chart review method for obtaining scores is questionable.
Raina
Ketki D
KD
University of Pittsburgh, School of Health and Rehabilitation Sciences, Department of Occupational Therapy, 5012 Forbes Tower, Pittsburgh, PA 15260, USA. kraina@pitt.edu
Callaway
Clifton
C
Rittenberger
Jon C
JC
Holm
Margo B
MB
D000328:Adult; D000368:Aged; D004185:Disability Evaluation; D005260:Female; D006305:Health Status Indicators; D006323:Heart Arrest / Q000503:physiopathology* / Q000523:psychology / Q000628:therapy; D006760:Hospitalization; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D009460:Neurologic Examination; D017063:Outcome Assessment, Health Care; D011788:Quality of Life; D020127:Recovery of Function; D015203:Reproducibility of Results; D013997:Time Factors