PT -期刊文章盟-亚历山德拉•鲁宾斯坦盟丽贝卡·斯塔福德AU -亚历山大·斯科特AU -卡罗莱纳马舍尔盟吉赛尔桑帕约席尔瓦AU -比克曼瑞秋非盟的艾米丽·吉尔摩盟-大卫·格里尔TI -差异Neuroprognostication Post-Cardiac逮捕患者的评估和临终决策- 10.1212 / WNL (S4.002)援助。0000000000203933 DP - 2023年4月25日TA -神经病首页学第六PG - 4365 - 100 IP - 17补充2 4099 - //www.ez-admanager.com/content/100/17_Supplement_2/4365.short 4100 - //www.ez-admanager.com/content/100/17_Supplement_2/4365.full所以Neurology2023 4月25日;100 AB -目的:描述neuroprognostication实践和供应商文档周围的昏迷post-cardiac逮捕病人临终决策。背景:撤军的维持生命的治疗(WLST),往往由于感知神经预后差(WLST-N),是最常见的死因心脏骤停后,无论逮捕病因。当前国际指南neuroprognostication心脏骤停后促进综合方法,包括瞳孔角膜反射、血清特异性神经元烯醇酶(研究)、脑电图(EEG)、躯体感觉诱发电位(SSEP)和神经影像。我们假设的理由记录WLST-N不会支持的客观比例的患者预后差的发现。设计/方法:我们进行了回顾性的图表总结post-cardiac被捕的病人从2011年到2018年,在两个三级学术医疗中心,WLST抽象数据,临床检查结果,和电生理学的和神经影像数据。测试和实践总结了底层neuroprognostication描述性统计。结果:112年WLST-N病人,WLST-N post-arrest天6天的中位数(差4天)。瞳孔和角膜反射出现在第三天post-arrest(或post-rewarming如果TTM-treated)在49.1%和34.8%的患者,分别。SSEP结果当作理由WLST-N在0.9% 8.0%的病人和研究结果。 EEG results were documented as a rationale for WLST-N in 25.0% of patients. MRI and CT results were cited as a rationale for WLST-N in 22.3% and 21.4% of patients, respectively. Variations of “unlikely to have meaningful improvement” were stated for 55.4% of WLST-N patients.Conclusions: Pessimistic, often vague neuroprognostic impressions were common despite limited reference to results of neuroprognostic tools, including NSE and SSEPs, and frequent reliance on neuroimaging results, which have conflicting levels of evidence. Consequently, current practices challenge granular characterization of WLST and may perpetuate confirmation bias of poor outcomes.Disclosure: Miss Rubenstein has nothing to disclose. Ms. Stafford has nothing to disclose. Alexander Scott has nothing to disclose. Dr. Maciel has received research support from American Heart Association. Dr. Maciel has received research support from National Institute of Health. Gisele Sampaio Silva has nothing to disclose. Dr. Beekman has nothing to disclose. The institution of Dr. Gilmore has received research support from NIH. Dr. Greer has received personal compensation in the range of $10,000-$49,999 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for Thieme, Inc. Dr. Greer has received personal compensation in the range of $5,000-$9,999 for serving as an Expert Witness for multiple. The institution of Dr. Greer has received research support from Becton Dickenson, Inc. Dr. Greer has received publishing royalties from a publication relating to health care.