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Neurologic prognosis after cardiopulmonary arrest; II. Level of consciousness

Departments of Neurology, University of Minnesota School of Medicine, and the St. Paul-Ramsey Medical Center, St. Paul, MN.

Sixty-three patients with isolated global anoxic-ischemic injury were prospectively evaluated after cardiopulmonary arrest (CPA); 25 (40%) survived, 16 to an excellent recovery, 8 to a good recovery, and 1 with severe deficits. Forty-six percent of the patients achieved full alertness, and only patients who did so survived. Seventy-five percent of patients arousable or initially alert (level of consciousness [LOC] 4) survived, all but two with excellent outcomes. Twenty-eight percent of patients initially in deep coma (LOC 3) survived, all with excellent or good outcomes. Ninety percent of patients who became fully alert did so within 72 hours. The likelihood of alerting is correlated with the LOC at given intervals after CPA. Reliable predictions of survival and outcome can often be based upon LOC alone within 2 days after CPA.

Address correspondence and reprint requests to Dr. Snyder, Department of Neurology, St. Paul-Ramsey Hospital, St. Paul, MN 55101.

Accepted for publication May 25, 1979

This work was supported in part by the St. Paul-Ramsey Hospital Medical Education & Research Foundation, Grant #8117.

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