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Open Access 01-12-2017 | Research

The association of findings on brain computed tomography with neurologic outcomes following extracorporeal cardiopulmonary resuscitation

Authors: Jeong-Am Ryu, Chi Ryang Chung, Yang Hyun Cho, Kiick Sung, Gee Young Suh, Taek Kyu Park, Young Bin Song, Joo-Yong Hahn, Jin-Ho Choi, Hyeon-Cheol Gwon, Seung-Hyuk Choi, Jeong Hoon Yang

Published in: Critical Care | Issue 1/2017

Abstract

Background

Limited data are available on imaging predictors of neurological outcomes after extracorporeal cardiopulmonary resuscitation (ECPR). We investigated the association of initial brain computed tomography (CT) findings with neurological outcomes following ECPR.

Methods

Between February 2005 and December 2015, a total of 42 patients who underwent brain CT scans within 48 h after ECPR were analyzed. Loss of the boundary between gray matter and white matter (LOB) or cortical sulcal effacement (SE), gray-to-white matter ratio (GWR), and optic nerve sheath diameter (ONSD) were measured on initial brain CT. The primary outcome was the Cerebral Performance Categories (CPC) scale at discharge.

Results

Of the 42 adult ECPR patients, 23 (54.8%) patients survived to discharge and 19 (45.2%) patients had good neurological outcomes (CPC 1 and 2). The area under the curve (AUC) of GWR in the basal ganglia (GWR-BG) was 0.792 (95% confidence interval (CI), 0.639–0.901, p = 0.001). ONSD (AUC 0.745; 95% CI, 0.587 – 0.867, p = 0.007) was 5.57 (interquartile range (IQR) 5.14 – 5.98) mm in the good neurological outcome group versus 6.07 (IQR 5.71 – 6.64) mm in the poor outcome group. LOB or SE were more often detected in the poor neurological outcome group (AUC 0.817; 95% CI, 0.682–0.952, p <0.001). The predictive performance of poor neurological outcomes of a composite of GWR-BG, ONSD, and LOB/SE was significantly improved (AUC 0.904; 95% CI, 0.773–0.973) compared to when each brain CT marker was considered separately (GWR-BG, p = 0.048; ONSD, p = 0.026; LOB/SE, p = 0.028).

Conclusions

GWR, ONSD, and LOB/SE on initial brain CT scans are associated with neurological prognosis in patients who underwent ECPR. The new risk prediction model, which uses a composite of GWR, ONCD, and LOB/SE, could provide better information on neurologic outcomes in patients underwent ECPR.

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Title: The association of findings on brain computed tomography with neurologic outcomes following extracorporeal cardiopulmonary resuscitation
Authors: Jeong-Am Ryu
Chi Ryang Chung
Yang Hyun Cho
Kiick Sung
Gee Young Suh
Taek Kyu Park
Young Bin Song
Joo-Yong Hahn
Jin-Ho Choi
Hyeon-Cheol Gwon
Seung-Hyuk Choi
Jeong Hoon Yang
Publication date: 01-12-2017
Publisher: BioMed Central
Published in: Critical Care / Issue 1/2017
Electronic ISSN: 1364-8535
DOI: https://doi.org/10.1186/s13054-017-1604-6

ACC 2024 Congress

Springer Medicine

The association of findings on brain computed tomography with neurologic outcomes following extracorporeal cardiopulmonary resuscitation

Abstract

Background

Methods

Results

Conclusions

ACC 2024 Congress

Springer Medicine

Abstract

Background

Methods

Results

Conclusions

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