Clinical Findings Predictive of Poor Outcome in Post Resuscitation Encephalopathy*

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APPENDIX E-1

Clinical Findings Predictive of Poor Outcome in Post Resuscitation Encephalopathy*

Clinical finding / Reference / Evidence class / Cohort size / Examination after CPR / Sensitivity** / False Positive Rate** /
Anoxia time > 5 min / 14 / I / 774 / On admission / 36 (32-40) / 20 (14-25)
Duration CPR > 20 min / 14 / I / 774 / On admission / 47 (43-51) / 23 (17-29)
Asystole or EMD / 14 / I / 774 / On admission / 48 (44-53) / 27 (21-33)
Body temperature / 15 / II / 151 / 48h / UTC≠ / UTC≠
GCS = 3 / 16 / II / 66 / 4-48h / 65 (52-79) / 24 (7-50)
GCS = 3 / 21 / III / 10 / ≤ 48h / 39 (7-71) / 0 (0-84)
GCS < 5 / 19 / III / 60 / 48h / 42 (28-56) / 0 (0-26)
GCS < 6 / 22 / III / 97 / 72h / 67 (56-77) / 15 (6-33%)
M ≤ 2 / 3 / I / 210 / On admission / 70 (63-77) / 42 (23-63)
M ≤ 2 / 3 / I / 210 / 24h / 58 (50-66) / 8 (1-25)
M ≤ 2 / 7 / I / 407 / 24h / 73 (68-79) / 33 (7-70)
M ≤ 2 / 7 / I / 407 / 48h / 71 (66-77) / 27 (6-61)
M ≤ 2 / 3 / I / 210 / 72h / 53 (43-63) / 0 (0-13)
M ≤ 2 / 17 / II / 34 / 72h / 55 (37-74) / 0 (0-41)
M ≤ 2 / 10 / I / 262 / 72h / 58 (48-68) / 0 (0-25)
M ≤ 2 / 7 / I / 407 / 72h / 71 (66-77) / 0 (0-41)
M ≤ 3 / 19 / III / 60 / 48h / 71 (58-84) / 25 (5-57)

APPENDIX (E)A3 (Continued)

Clinical finding / Reference / Evidence class / Cohort size / Examination time after CPR / Sensitivity** / False Positive Rate** /
> 1 BSR absent / 19 / III / 60 / 24h / 11 (2-20) / 0 (0-27)
> 1 BSR absent / 19 / III / 60 / 48h / 7 (0-14) / 0 (0-27)
PLR absent / 3 / I / 210 / On admission / 28 (22-35) / 0 (0-14)
PLR absent / 3 / I / 210 / 24h / 21 (14-27) / 0 (0-14)
PLR absent / 7 / I / 407 / 24h / 18 (13-22) / 0 (0-34)
PLR absent / 7 / I / 407 / 48h / 19 (14-24) / 0 (0-29)
PLR absent / 3 / I / 210 / 72h / 12 (5-18) / 0 (0-14)
PLR absent / 10 / I / 262 / 72h / 19 (11-27) / 0 (0-25)
PLR absent / 7 / I / 407 / 72h / 22 (17-27) / 0 (0-46)
CR absent / 3 / I / 210 / On admission / 39 (31-46) / 1 (3-31)
CR absent / 3 / I / 210 / 24h / 28 (21-36) / 0 (0-14)
CR absent / 7 / I / 407 / 24h / 31 (26-37) / 11 (0-48)
CR absent / 7 / I / 407 / 48h / 28 (22-33) / 0 (0-29)
CR absent / 3 / I / 210 / 72h / 16 (8-23) / 0 (0-14)
CR absent / 7 / I / 407 / 72h / 28 (22-33) / 0 (0-41)
Eye movements absent / 7 / I / 407 / 24h / 50 (44-57) / 33 (7-70)
Eye movements absent / 7 / I / 407 / 48h / 47 (41-53) / 9 (0-41)
Eye movements absent / 7 / I / 407 / 72h / 43 (36-49) / 0 (0-41)

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APPENDIX (E)A3 (Continued) /
Clinical finding / Reference / Evidence class / Cohort size / Examination time after CPR / Sensitivity** / False Positive Rate** /
Vertical eye deviation / 18 / III / 50 / < 72h / 61 (46-76) / 33 (7-70)
Seizures or myoclonus / 7 / I / 407 / 24h / 34 (29-39) / 20 (7-41)
Seizures or myoclonus / 19 / III / 60 / 72h / 50 (36-64) / 8 (0-39)
Status epilepticus / 7 / I / 407 / 24h / 2 (1-3) / 0 (0-14)
Myoclonus status epilepticus / 7 / I / 407 / 24h / 4 (2-7) / 0 (0-14)
Myoclonus status epilepticus / 20 / III / 106 / 24h / 44 (48-71) / 0 (0-22)

EMD: Electromechanical dissociation

GCS: Glasgow Coma Scale

CPR: Cardiopulmonary resuscitation

BSR = Brain Stem Reflexes (pupillary light reflex, cornea reflex, oculocephalic reflex); CR = Cornea Reflex; GCS = Glasgow Coma Scale

M = motor response of the Glasgow Coma Scale; M1 = no response to pain, M2 = extensor response to pain, M3 = decorticate response.

PLR = Pupillary Light Reflex; h = hour

*See text (selection of studies) for definition of poor outcome.

**Numbers indicate percentage. Exact 95% confidence limits are in parentheses.

≠UTC: Unable to calculate – see text for odds ratios.