title: Long-term neurological outcomes in patients after out-of-hospital cardiac arrest.
abstract: OBJECTIVE
  The main treatment goal in survivors of out-of-hospital cardiac arrest (OHCA) is a favorable neurologic outcome. Little is known, however, about long-term trends of neurologic status in OHCA survivors. This study was designed to assess the rates of long-term neurologic recovery and survival according to neurologic status at one month.
  
  
  METHODS
  This retrospective observational study assessed all adult OHCA survivors (≥18 years) admitted to a tertiary hospital in an urban area who achieved return of spontaneous circulation (ROSC) between July 2005 and August 2013. Neurologic outcomes were measured by Cerebral Performance Category (CPC) score and patients were categorized according to CPC score at 1 month. Their neurologic status was re-evaluated 6, 12, and 24 months after cardiac arrest.
  
  
  RESULTS
  Of 778 OHCA cases, 282 patients (36.2%) were admitted to our hospital, and 279 were included in this study. At one month, 84 (30.1%) survivors were assessed with the CPC with 42.8% (n=36) having good neurologic outcome and 57.1% (n=48) poor neurologic outcome. Only two patients with poor neurologic outcome (4.1%) showed improved neurologic status from CPC 3 to CPC 2, during the first 6 months and none showed neurologic improvement after 6 months. The estimated 3-year survival was much higher for CPC 1 (96.4%) than for CPC 4 (24.2%) survivors.
  
  
  CONCLUSIONS
  Neurologic recovery of OHCA survivors with poor neurologic outcomes at one month was rare and did not occur more than 6 months after cardiac arrest.
authors.affiliation: Department of Emergency Medicine, University of Ulsan College of Medicine, Asan Medical Center, Seoul, South Korea.
authors.forename: Youn-Jung
authors.initials: YJ
authors.lastname: Kim
authors.affiliation: Department of Emergency Medicine, University of Ulsan College of Medicine, Asan Medical Center, Seoul, South Korea.
authors.forename: Shin
authors.initials: S
authors.lastname: Ahn
authors.affiliation: Department of Emergency Medicine, University of Ulsan College of Medicine, Asan Medical Center, Seoul, South Korea.
authors.forename: Chang Hwan
authors.initials: CH
authors.lastname: Sohn
authors.affiliation: Department of Emergency Medicine, University of Ulsan College of Medicine, Asan Medical Center, Seoul, South Korea.
authors.forename: Dong-Woo
authors.initials: DW
authors.lastname: Seo
authors.affiliation: Department of Emergency Medicine, University of Ulsan College of Medicine, Asan Medical Center, Seoul, South Korea.
authors.forename: Yoon-Seon
authors.initials: YS
authors.lastname: Lee
authors.affiliation: Department of Emergency Medicine, University of Ulsan College of Medicine, Asan Medical Center, Seoul, South Korea.
authors.forename: Jae Ho
authors.initials: JH
authors.lastname: Lee
authors.affiliation: Department of Emergency Medicine, University of Ulsan College of Medicine, Asan Medical Center, Seoul, South Korea.
authors.forename: Bum Jin
authors.initials: BJ
authors.lastname: Oh
authors.affiliation: Department of Emergency Medicine, University of Ulsan College of Medicine, Asan Medical Center, Seoul, South Korea.
authors.forename: Kyoung Soo
authors.initials: KS
authors.lastname: Lim
authors.affiliation: Department of Emergency Medicine, University of Ulsan College of Medicine, Asan Medical Center, Seoul, South Korea. Electronic address: wonpia73@naver.com.
authors.forename: Won Young
authors.initials: WY
authors.lastname: Kim
mesh_terms: D000328:Adult; D000368:Aged; D001921:Brain / Q000502:physiology*; D016887:Cardiopulmonary Resuscitation; D015331:Cohort Studies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D058687:Out-of-Hospital Cardiac Arrest / Q000628:therapy*; D020127:Recovery of Function; D012189:Retrospective Studies; D017741:Survivors; D013997:Time Factors
keywords: Cerebral Performance Category score; Long term; Out-of-hospital cardiac arrest; Prognosis