Young Hwan Lee1, Young Taeck Oh1, Hee Cheol Ahn2, Hyoung Soo Kim3, Sang Jin Han4, Jae Jun Lee5, Tae Hun Lee6, Jeong Yeol Seo6, Dong Hyuk Shin7, Sang Ook Ha8, Sang O Park9. 1. Department of Emergency Medicine, Hallym University Sacred Heart Hospital, Hallym University, Anyang-si, Gyeonggi-do, Republic of Korea; Department of emergency medicine, College of Medicine, Kangwon National University, Chuncheon, Gangwon 200-701, Republic of Korea. 2. Department of Emergency Medicine, Hallym University Sacred Heart Hospital, Hallym University, Anyang-si, Gyeonggi-do, Republic of Korea. Electronic address: gsemdr68@hallym.or.kr. 3. Department of Thoracic and Cardiovascular Surgery, Hallym University Medical Center, Hallym University College of Medicine, 77 Sakju-ro, Chuncheon 200-704, Republic of Korea. Electronic address: cskhs99@hallym.ac.kr. 4. Division of Cardiology, Department of Internal Medicine, Hallym University Medical Center, Hallym University College of Medicine, 77 Sakju-ro, Chuncheon 200-704, Republic of Korea. 5. Department of Anesthesiology, School of Medicine, Hallym University, Chuncheon, Republic of Korea. 6. Department of Emergency Medicine, School of Medicine, Hallym University, Chuncheon, Republic of Korea. 7. Department of Emergency Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea. 8. Department of Emergency Medicine, Hallym University Sacred Heart Hospital, Hallym University, Anyang-si, Gyeonggi-do, Republic of Korea. 9. Department of Emergency Medicine, School of medicine, Konkuk University Konkuk University Medical Center, Seoul, Republic of Korea.
Abstract
AIM: The grey-to-white matter ratio (GWR) is a reliable predictor of the neurological outcome of out-of-hospital cardiac arrest (OHCA). However, the reliability in patients receiving extracorporeal membrane oxygenation-assisted cardiopulmonary resuscitation (ECPR) remains unknown. We evaluated the utility of the GWR in predicting neurological outcomes in ECPR-treated patients. METHODS: This single-centre retrospective study was conducted from July 2009 to January 2014. Patients who received ECPR for OHCA were classified into two groups: Cerebral performance category(CPC) 1-2 was defined as good, CPC 3-5 as poor outcome. Four GWR (GWR-AV[average], GWR-CO[cortex], GWR-BG[basal ganglia], and GWR-SI [simplified])were evaluated and compared between the groups. RESULTS: Of 38 patients who received ECPR for OHCA, 30 patients were enrolled. Five (16.7%) had a good outcome and 25(83.3%) a poor outcome. All GWR were significantly higher in the good outcome group than in the poor outcome group. ROC curve analysis produced the following areas under the curve: GWR-AV=0.920 (95% CI 0.761 to 0.987), GWR-BG=0.872 (95%CI 0.699 to 0.965), GWR-CO=0.952 (95% CI 0.806 to 0.997), and GWR-SI=0.848(95% CI 0.670 to 0.962). The cut-off value with 100% specificity for the prediction of the poor outcome was 1.23 for GWR-AV (sensitivity: 76%), 1.24 for GWR-BG (sensitivity: 88.0%), 1.22 for GWR-CO (sensitivity: 64%), and 1.21 for GWR-SI (sensitivity: 76%). CONCLUSIONS: In ECPR, GWR of patients with poor outcome was significantly lower than that of patients with good outcome.
AIM: The grey-to-white matter ratio (GWR) is a reliable predictor of the neurological outcome of out-of-hospital cardiac arrest (OHCA). However, the reliability in patients receiving extracorporeal membrane oxygenation-assisted cardiopulmonary resuscitation (ECPR) remains unknown. We evaluated the utility of the GWR in predicting neurological outcomes in ECPR-treated patients. METHODS: This single-centre retrospective study was conducted from July 2009 to January 2014. Patients who received ECPR for OHCA were classified into two groups: Cerebral performance category(CPC) 1-2 was defined as good, CPC 3-5 as poor outcome. Four GWR (GWR-AV[average], GWR-CO[cortex], GWR-BG[basal ganglia], and GWR-SI [simplified])were evaluated and compared between the groups. RESULTS: Of 38 patients who received ECPR for OHCA, 30 patients were enrolled. Five (16.7%) had a good outcome and 25(83.3%) a poor outcome. All GWR were significantly higher in the good outcome group than in the poor outcome group. ROC curve analysis produced the following areas under the curve: GWR-AV=0.920 (95% CI 0.761 to 0.987), GWR-BG=0.872 (95%CI 0.699 to 0.965), GWR-CO=0.952 (95% CI 0.806 to 0.997), and GWR-SI=0.848(95% CI 0.670 to 0.962). The cut-off value with 100% specificity for the prediction of the poor outcome was 1.23 for GWR-AV (sensitivity: 76%), 1.24 for GWR-BG (sensitivity: 88.0%), 1.22 for GWR-CO (sensitivity: 64%), and 1.21 for GWR-SI (sensitivity: 76%). CONCLUSIONS: In ECPR, GWR of patients with poor outcome was significantly lower than that of patients with good outcome.
Authors: Tom P Aufderheide; Rajat Kalra; Marinos Kosmopoulos; Jason A Bartos; Demetris Yannopoulos Journal: Ann N Y Acad Sci Date: 2021-02-20 Impact factor: 5.691
Authors: Heekyung Lee; Joonkee Lee; Hyungoo Shin; Changsun Kim; Hyuk-Joong Choi; Bo-Seung Kang Journal: Int J Environ Res Public Health Date: 2021-06-18 Impact factor: 3.390