Resuscitation · 2020
The prognostic performance of brain ventricular characteristic differ according to sex, age, and time after cardiac arrest in comatose out-of-hospital cardiac arrest survivors.
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Lee Byung Kook, Callaway Clifton W, Coppler Patrick J, Rittenberger Jon C, Pittsburgh Post-Cardiac Arrest Service
Аннотация
AIM: We tested the consistency of ventricular characteristics measurement on brain computed tomography (CT) and investigated the prognostic performance of ventricular characteristics by sex, age, and time of brain CT in out-of-hospital cardiac arrest (OHCA) survivors.
METHODS: We conducted a retrospective study of adult comatose OHCA survivors who underwent targeted temperature management and brain CT within 24 h after cardiac arrest (CA) between January 2010 and December 2018. We calculated gray-to-white matter ratio (GWR) of Hounsfield units, ventricular area (lateral, third, and fourth), and ventricular diameter (third and fourth). We divided time of brain CT after CA into three epochs: ≤2 h, 2-6 h, and 6-24 h. Male and female group was divided into two groups with cutoff of 50 and 60 years, respectively. The primary outcome was in-hospital mortality.
RESULTS: Of 902 included patients, 218 (24.2%) survived to discharge. Ventricular characteristics had intra-class correlation coefficient (ICC) of 0.886-0.991, while GWR had an ICC (0.842). Area and diameter of fourth ventricle had significant prognostic performance in the whole group. Ventricular characteristics at 6-24 h had significant prognostic performance, while all ventricular characteristics had no significant performance at ≤2 h. Ventricular characteristics had significant prognostic performance in young male and female sub-groups, whereas not all ventricular characteristics had significant prognostic performance in old sub-groups.
CONCLUSIONS: The measurement of ventricular characteristics on brain CT was consistent in OHCA survivors. The prognostic performance of ventricular characteristics was best for brain CT 6-24 h after CA and differed according to age and sex sub-groups.
METHODS: We conducted a retrospective study of adult comatose OHCA survivors who underwent targeted temperature management and brain CT within 24 h after cardiac arrest (CA) between January 2010 and December 2018. We calculated gray-to-white matter ratio (GWR) of Hounsfield units, ventricular area (lateral, third, and fourth), and ventricular diameter (third and fourth). We divided time of brain CT after CA into three epochs: ≤2 h, 2-6 h, and 6-24 h. Male and female group was divided into two groups with cutoff of 50 and 60 years, respectively. The primary outcome was in-hospital mortality.
RESULTS: Of 902 included patients, 218 (24.2%) survived to discharge. Ventricular characteristics had intra-class correlation coefficient (ICC) of 0.886-0.991, while GWR had an ICC (0.842). Area and diameter of fourth ventricle had significant prognostic performance in the whole group. Ventricular characteristics at 6-24 h had significant prognostic performance, while all ventricular characteristics had no significant performance at ≤2 h. Ventricular characteristics had significant prognostic performance in young male and female sub-groups, whereas not all ventricular characteristics had significant prognostic performance in old sub-groups.
CONCLUSIONS: The measurement of ventricular characteristics on brain CT was consistent in OHCA survivors. The prognostic performance of ventricular characteristics was best for brain CT 6-24 h after CA and differed according to age and sex sub-groups.