• Noritoshi Ito, Kei Nishiyama, Clifton W Callaway, Tomohiko Orita, Kei Hayashida, Hideki Arimoto, Mitsuru Abe, Tomoyuki Endo, Akira Murai, Ken Ishikura, Noriaki Yamada, Masahiro Mizobuchi, Hideki Anan, Kazuo Okuchi, Hideto Yasuda, Toshiaki Mochizuki, Yuka Tsujimura, Takeo Nakayama, Tetsuo Hatanaka, Ken Nagao, and J-POP Registry Investigators.
• Senri Cardiovascular Center, Osaka Saiseikai Senri Hospital, 1-1-6 Tsukumodai, Suita, Osaka 565-0862, Japan; Department of Cardiovascular Medicine, Osaka University Graduate School of Medicine, 2-2 Yamadaoka, Suita, Osaka 565-0871, Japan.
• Resuscitation. 2014 Jun 1; 85 (6): 778-84.

AimTo investigate the association between regional brain oxygen saturation (rSO2) at hospital arrival and neurological outcomes at 90 days in patients with out-of-hospital cardiac arrest (OHCA).MethodsThe Japan-Prediction of neurological Outcomes in patients post cardiac arrest (J-POP) registry is a prospective, multicenter, cohort study to test whether rSO2 predicts neurological outcomes after OHCA. We measured rSO2 in OHCA patients immediately after hospital arrival using a near-infrared spectrometer placed on the forehead with non-blinded fashion. The primary endpoint was "neurological outcomes" at 90 days after OHCA.ResultsEMS providers are not permitted to terminate CPR in the field in Japan, and so most patients with OHCA who are treated by EMS personnel are transported to emergency hospitals. Among 1017 OHCA patients, 672 patients including 52 comatose patients with pulses detectable (8%) and 620 cardiac arrest patients (92%) at hospital arrival were enrolled prospectively and consecutively. Twenty-nine patients with good neurological outcome had a significantly higher value of rSO2 at hospital arrival than 643 patients with poor neurological outcome (mean [±SD] 55.6±20.8% vs. 19.7±11.0%, p<0.001). Receiver operating curve analysis indicated an optimal rSO2 cutoff point of >42% for predicting good neurological outcome, with sensitivity 0.79 (95% confidence interval [CI], 0.60-0.92), specificity 0.95 (95% CI, 0.93-0.96), positive predictive value, 0.41 (95% CI, 0.28-0.55), negative predictive value, 0.99 (95% CI, 0.98-1.00), and area under the curve 0.90 (95% CI, 0.88-0.92).ConclusionThe rSO2 at hospital arrival can predict good neurological outcome at 90 days after OHCA.Copyright © 2014 The Authors. Published by Elsevier Ireland Ltd.. All rights reserved.

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