• Toru Hifumi, Yasuhiro Kuroda, Kenya Kawakita, Hirotaka Sawano, Yoshio Tahara, Mamoru Hase, Kenji Nishioka, Shinichi Shirai, Hiroshi Hazui, Hideki Arimoto, Kazunori Kashiwase, Shunji Kasaoka, Tomokazu Motomura, Yuji Yasuga, Naohiro Yonemoto, Hiroyuki Yokoyama, Ken Nagao, Hiroshi Nonogi, and J-PULSE-Hypo Investigators.
• Emergency Medical Center, Kagawa University Hospital.
• Circ. J. 2015 Jan 1; 79 (10): 2201-8.

BackgroundBecause the initial (on admission) Glasgow Coma Scale (GCS) examination has not been fully evaluated in comatose survivors of cardiac arrest (CA) who receive therapeutic hypothermia (TH), the aim of the present study was to determine any association between the admission GCS motor score and neurologic outcomes in patients with out-of-hospital CA who receive TH.Methods And ResultsIn the J-PULSE-HYPO study registry, patients with bystander-witnessed CA were eligible for inclusion. Patients were divided into 3 groups based on GCS motor score (1, 2-3, and 4-5) to assess various effects on neurologic outcome. Univariate and multivariate analyses were performed to identify independent predictors of good neurologic outcome at 90 days. Of 452 patients, 302 were enrolled. There was a significant difference among the 3 patient groups with regard to neurologic outcome at 90 days in the univariate analysis. Multiple logistic regression analyses showed that the GCS motor score on admission, age >65 years, bystander cardiopulmonary resuscitation, the time from collapse to return of spontaneous circulation, and pupil size <4 mm were independent predictors of a good neurologic outcome at 90 days in cases of CA (GCS motor score, 4-5: odds ratio, 8.18; 95% confidence interval: 1.90-60.28; P<0.01).ConclusionsGCS motor score is an independent predictor of good neurologic outcome at 90 days in patients sustaining out-of-hospital CA who receive TH.

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