Kardiyak Arrest Olgularında Kranial Bilgisayarlı Tomografinin Hasta Prognozunu Belirlemedeki Yeri
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Date
2018-02Author
Kasap, Gül Nihal
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KASAP GN. Role of Cranial Computed Tomography in Prognosis in cases of
Cardiac Arrest. Hacettepe University Faculty of Medicine, Emergency Medicine
Thesis. Ankara, 2018. Cardiac Arrest is the sudden loss of heart function in patients
with or without a diagnosed heart disease. Every year more than 55.3 million cases of
cardiac arrest are registered in Emergency Services around the world. Between
January 1, 2000 and August 31, 2017 among the patients that had the Cranial CT
scan following the return of spontaneous circulation (ROSC) after the cardiac arrest
and cardiopulmonary resuscitation (CPR) in Hacettepe University Adult Emergency
Services, followings are retrospectively investigated: patients‘ demographic
information, vital signs, blood gas results, CT results, and MRI results. Living
conditions of patients are compared on 24-hour and 6-month bases, the statistical
analysis covers 207 patients.The overall average age of the patients was 68,62 (19-
98), 39,1% (n = 81) and 60,9% (n = 126) of these patients were male and female
respectively. Of the patients, 112 (54.4%) were in-hospital arrest cases. 147 patients
(71%) developed cardiac arrest due to non-cardiac causes. The cardiac rhythm first
detectedduring CPR of the patients was 8.7% shockable rhythms and 91.3% nonshockable
rhythms. When the blood gas parameters of the patients were examined,
high lactate level was associated with increased mortality in the first 24-hour survival
(P = 0.003). The high value of pO2 in blood gases after CPR was associated with
mortality in the first 24 hours (P = 0.040). There was no significant difference
between the surviving and non-surviving patient groups when the BrANOS score
was examined at 24-hour and 6-month survival. From CT scan findings, the most
seen was atrophy (45.9%), followed by hypoxic edema (20.8%). When 24-hour and
6-month survival rates are investigated, dead patient rate were higher in male
patients. The average life expectancy of patients is calculated as 11 days. The risk of
death in patients with hypoxic edema was found to be increased by 2 times. MRI was
performed in 26.6% of patients (n = 55). On MRI of patients with hypoxic edema,
hypoxic edema was seen in 86% (p = 0.012).