BrainWaves: A Neurology Podcast

#137 Neurologists as medical actuaries

BrainWaves: A Neurology Podcast

For patients who survive cardiopulmonary arrest, but do not wake up, neurologists are called to the bedside to prognosticate. And the question of 'How much will this patient recover?' is not unlike 'What is the benefit of aggressive therapy to await possible recovery?' In that way, you might consider neurologists to be the actuaries of hospital medicine. In this week's program, we review the clinical and diagnostic data that neurologists incorporate into their model for outcome prediction following anoxic brain injury.

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Produced by James E. Siegler. Music courtesy of Swelling, Soft and Furious, Rafael Archangel, Lovira, and Dark Room. Sound effects by Mike Koenig and Daniel Simion. BrainWaves' podcasts and online content are intended for medical education only and should not be used for clinical decision making. Be sure to follow us on Twitter @brainwavesaudio for the latest updates to the podcast.

REFERENCES

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  3. Sandroni C and D'Arrigo S. Neurologic Prognostication: Neurologic Examination and Current Guidelines. Semin Neurol. 2017;37:40-47.
  4. Nielsen N, Wetterslev J, Cronberg T, Erlinge D, Gasche Y, Hassager C, Horn J, Hovdenes J, Kjaergaard J, Kuiper M, Pellis T, Stammet P, Wanscher M, Wise MP, Aneman A, Al-Subaie N, Boesgaard S, Bro-Jeppesen J, Brunetti I, Bugge JF, Hingston CD, Juffermans NP, Koopmans M, Kober L, Langorgen J, Lilja G, Moller JE, Rundgren M, Rylander C, Smid O, Werer C, Winkel P, Friberg H and Investigators TTMT. Targeted temperature management at 33 degrees C versus 36 degrees C after cardiac arrest. The New England journal of medicine. 2013;369:2197-206.
  5. Seder DB. Management of Comatose Survivors of Cardiac Arrest. Continuum (Minneap Minn). 2018;24:1732-1752.
  6. Booth CM, Boone RH, Tomlinson G and Detsky AS. Is this patient dead, vegetative, or severely neurologically impaired? Assessing outcome for comatose survivors of cardiac arrest. JAMA : the journal of the American Medical Association. 2004;291:870-9.
  7. Callaway CW, Donnino MW, Fink EL, Geocadin RG, Golan E, Kern KB, Leary M, Meurer WJ, Peberdy MA, Thompson TM and Zimmerman JL. Part 8: Post-Cardiac Arrest Care: 2015 American Heart Association Guidelines Update for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care. Circulation. 2015;132:S465-82.
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