Both decreased and increased grey-to-white matter attenuation ratio in the putamen and caudate on early head computed tomography differentiate patients with favorable and unfavorable outcomes after prolonged cardiac arrest-secondary analysis of the Prague OHCA study

Result code in IS VaVaI

<a href="https://www.isvavai.cz/riv?ss=detail&h=RIV%2F00064165%3A_____%2F23%3A10466770" target="_blank" >RIV/00064165:_____/23:10466770 - isvavai.cz</a>

Alternative codes found

RIV/00216208:11110/23:10466770

Result on the web

<a href="https://verso.is.cuni.cz/pub/verso.fpl?fname=obd_publikace_handle&handle=N4GF9VfKFf" target="_blank" >https://verso.is.cuni.cz/pub/verso.fpl?fname=obd_publikace_handle&handle=N4GF9VfKFf</a>

DOI - Digital Object Identifier

<a href="http://dx.doi.org/10.21037/qims-23-430" target="_blank" >10.21037/qims-23-430</a>

Result language

angličtina

Original language name

Both decreased and increased grey-to-white matter attenuation ratio in the putamen and caudate on early head computed tomography differentiate patients with favorable and unfavorable outcomes after prolonged cardiac arrest-secondary analysis of the Prague OHCA study

Original language description

Background: Neurological damage remains the leading cause of death in cardiac arrest victims with early neuroprognostication being the cornerstone of the decision-making process to continue or discontinue advanced treatments. In this study, we aimed to find markers of favorable and unfavorable outcome on early brain computed tomography (CT) in patients after prolonged out-of-hospital cardiac arrest (OHCA) treated both by conventional and extracorporeal cardiopulmonary resuscitation (ECPR).Methods: In a secondary analysis of the Prague OHCA study, patients who underwent brain CT within 36 hours after cardiac arrest were identified. Qualitative findings (brain edema, hemorrhage) and quantitative measurements [attenuation of grey matter structures and grey-to-white matter attenuation ratio (GWR)] between patients with cerebral performance category (CPC) of 1-2 (favorable outcome) and 3-5 (unfavorable outcome) within 180 days after the event were compared.Results: In 45 eligible patients, intracranial edema (n=16, 50%) was present in patients with CPC 3-5 only (n=32, 71%). Attenuation of brain structures and GWR did not differ between patients with favorable and unfavorable outcomes. However, the GWR in the caudate and putamen of most CPC 1-2 patients was within a narrow range of values (1.18 to 1.30 and 1.20 to 1.33) that separated patients with CPC 1-2 from CPC 3-5 with a sensitivity of 85% and 100%, a specificity of 78% and 66%, and AUC of 0.86 (P=0.0001) and 0.77 (P=0.0053), respectively. Patients treated by ECPR had lower attenuation in the centrum semiovale (28.3 &amp; PLUSMN;2.7) compared to those who were not (31.0 &amp; PLUSMN;2.8, P=0.003). The most common causes of death in CPC 3-5 patients were brain death in 13 (41%) patients, multiorgan failure in 12 (38%), and cardiac rearrest in 4 (13%). Conclusions: Both decreased and increased grey-to-white matter differentiation in the putamen and caudate on early non-contrast brain CT after prolonged OHCA indicate poor neurological outcome within 180 days after cardiac arrest.

Czech name

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Czech description

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Type

J_imp - Article in a specialist periodical, which is included in the Web of Science database

CEP classification

—

OECD FORD branch

30224 - Radiology, nuclear medicine and medical imaging

Project

—

Continuities

I - Institucionalni podpora na dlouhodoby koncepcni rozvoj vyzkumne organizace

Publication year

2023

Confidentiality

S - Úplné a pravdivé údaje o projektu nepodléhají ochraně podle zvláštních právních předpisů

Name of the periodical

Quantitative Imaging in Medicine and Surgery

ISSN

2223-4292

e-ISSN

2223-4306

Volume of the periodical

13

Issue of the periodical within the volume

9

Country of publishing house

HK - HONG KONG

Number of pages

10

Pages from-to

6205-6214

UT code for WoS article

001044658200001

EID of the result in the Scopus database

2-s2.0-85171150965