title: Cerebral Performance Category and long-term prognosis following out-of-hospital cardiac arrest.
abstract: OBJECTIVE
  Although measures of functional status are often advocated when assessing short-term survival following cardiac arrest, little is known about how these measures predict long-term prognosis. We sought to determine whether the Cerebral Performance Category (CPC) was associated with long-term outcome following resuscitation from out-of-hospital cardiac arrest.
  
  
  METHODS
  The study was a retrospective cohort investigation of adults who suffered out-of-hospital cardiac arrest in the study community between January 1, 2001 and December 31, 2009, and were successfully resuscitated and discharged alive from the hospital following the event. The CPC at the time of hospital discharge was ascertained through review of the hospital record. The primary outcome was survival following hospital discharge. Survival status was determined using state and national death indexes. We used Kaplan-Meier curves and Cox regression to evaluate the association between CPC and survival.
  
  
  RESULTS
  Among the 980 eligible subjects, 606 of 980 (62%) had a CPC of 1; 227 of 980 (23%) had a CPC of 2; 97 of 980 (10%) had a CPC of 3; and 50 of 980 (5%) had a CPC of 4. There were 336 deaths during 3,713 person-years of follow-up. Overall, 1-year survival was 82% and 5-year survival was 64%. Favorable CPC predicted better long-term prognosis. Compared with CPC 1, the relative risk of survival was 0.61 (0.47-0.80) for CPC 2, 0.43 (0.31-0.59) for CPC 3, and 0.10 (0.06-0.15) for CPC 4.
  
  
  CONCLUSIONS
  The CPC at hospital discharge is a useful surrogate measure of long-term survival and can be an informative tool for programmatic evaluation and research of resuscitation.
authors: Division of Emergency Medical Services, Public Health - Seattle & King County, University of Washington, Seattle, WA, USA. randi.phelps@kingcounty.gov
authors: Randi
authors: R
authors: Phelps
authors: Florence
authors: F
authors: Dumas
authors: Charles
authors: C
authors: Maynard
authors: Jennifer
authors: J
authors: Silver
authors: Thomas
authors: T
authors: Rea
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D016887:Cardiopulmonary Resuscitation / Q000379:methods* / Q000401:mortality; D003072:Cognition Disorders / Q000175:diagnosis / Q000401:mortality; D015331:Cohort Studies; D003266:Continuity of Patient Care; D018572:Disease-Free Survival; D004632:Emergency Medical Services / Q000458:organization & administration; D005260:Female; D015600:Glasgow Coma Scale; D006801:Humans; D053208:Kaplan-Meier Estimate; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D009422:Nervous System Diseases / Q000175:diagnosis* / Q000401:mortality; D058687:Out-of-Hospital Cardiac Arrest / Q000401:mortality / Q000628:therapy*; D010351:Patient Discharge / Q000706:statistics & numerical data*; D011379:Prognosis; D016016:Proportional Hazards Models; D012189:Retrospective Studies; D018570:Risk Assessment; D012737:Sex Factors; D015996:Survival Rate; D017741:Survivors; D013647:Task Performance and Analysis; D013997:Time Factors