Grey-white matter ratio measured using early unenhanced brain computed tomography shows no correlation with neurological outcomes in patients undergoing targeted temperature management after cardiac arrest
- 주제(키워드) Grey-white matter ratio , Cardiac arrest , Neurological outcome , Targeted temperature management , Post-cardiac arrest syndrome , Prognostic factor
- 주제(기타) Critical Care Medicine; Emergency Medicine
- 설명문(일반) [Hong, Jun Young; Lee, Dong Hoon; Oh, Je Hyeok] Chung Ang Univ, Coll Med, Dept Emergency Med, 102 Heukseok Ro, Seoul, South Korea; [Lee, Sun Hwa] Inje Univ, Sanggye Paik Hosp, Dept Emergency Med, Dongil Ro 1342, Seoul, South Korea; [Choi, Yoon Hee] Ewha Womans Univ, Emergency Med, 1071 Anyangcheon Ro, Seoul, South Korea; [Kim, Soo Hyun] Catholic Univ Korea, Coll Med, St Marys Hosp, Dept Emergency Med, 222 Banpo Daero, Seoul, South Korea; [Min, Jin Hong] Chungnam Natl Univ Hosp, Dept Emergency Med, 282 Munhwa Ro, Daejeon, South Korea; [Kim, Su Jin] Korea Univ, Coll Med, Dept Emergency Med, Inchon Ro 73, Seoul 02841, South Korea; [Park, Yoo Seok] Yonsei Univ, Coll Med, Dept Emergency Med, 50 Yonsei Ro, Seoul 03722, South Korea
- 등재 SCIE, SCOPUS
- 발행기관 ELSEVIER IRELAND LTD
- 발행년도 2019
- URI http://www.dcollection.net/handler/ewha/000000160207
- 본문언어 영어
- Published As http://dx.doi.org/10.1016/j.resuscitation.2019.03.039
- PubMed https://pubmed.ncbi.nlm.nih.gov/30953628
초록/요약
Aim: This study evaluated whether the grey-white matter ratio (GWR) assessed via early brain computed tomography (CT) within 2 h after the return of spontaneous circulation (ROSC) following cardiac arrest is associated with poor neurological outcomes after 6 months in post-cardiac arrest patients treated with targeted temperature management (TTM). Methods: This study used data from the Korean Hypothermia Network prospective registry obtained from November 2015 to October 2017 to assess patients with out-of-hospital cardiac arrest (OHCA) who underwent brain CT within 2 h following the ROSC. The primary endpoint was the neurological outcome 6 months post-cardiac arrest (cerebral performance category; CPC). The GWR was measured using early brain CT images. The subgroup analysis examined the difference in GWRs obtained from early and repeated brain CT. Results: Five-hundred-twelve patients were enrolled. Good (CPC 1-2) and poor (CPC 3-5) neurological outcomes were observed in 162 (31.6%, 4 and 350 (68.4%, 4 patients, respectively. The multivariate logistic regression analysis revealed that the GWR measured using early brain CT was a statistically nonsignificant predictor of poor neurologic outcomes (p = 0.727). In patients with poor outcomes, the mean GWR obtained from early and repeated CT images were 1.171 +/- 0.058 and 1.091 +/- 0.133, respectively (p 0.001); there was no statistically significant difference between the GWRs in patients with good outcomes. Conclusion: The GWR assessed via early brain CT alone is not an independent factor predictive of poor neurologic outcomes but could be useful when used with repeated CT data.
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