Hooi-Nee Ong1, Wen-Jone Chen1, Po-Ya Chuang2, Bo-Ching Lee3, Chien-Hua Huang1, Chun-Chieh Huang4, Wei-Tien Chang1, Min-Shan Tsai1,5. 1. National Taiwan University Medical College and Hospital Department of Emergency Medicine Taipei Taiwan. 2. Taipei Medical University School of Health Care Administration Taipei Taiwan. 3. National Taiwan University Medical College and Hospital Department of Radiology Taipei Taiwan. 4. Far Eastern Memorial Hospital Department of Radiology New Taipei City Taiwan. 5. National Taiwan University Hospital Hsin-Chu Branch Department of Emergency Medicine Hsinchu Taiwan.
Abstract
BACKGROUND: The gray-white-matter ratio (GWR) measured on cerebral non-contrasted computed tomography (NCCT) has been reported to help the prognostication of mortality or comatose status of out-of-hospital cardiac arrest (OHCA) victims. Since the etiologies and resuscitative process differ significantly between patients with OHCA and in-hospital cardiac arrest (IHCA), the predictive ability of GWR in IHCA survivors remains unclear. METHODS: This retrospective observational study conducted in a single tertiary medical center in Taiwan enrolled all the non-traumatic IHCA adults with sustained return of spontaneous circulation (ROSC) and had received cerebral NCCT examination within 24 hours following cardiac arrest. The GWR of survivor and non-survivor as well as good and poor neurological outcome were analyzed. RESULTS: A total of 79 IHCA patients with 68.4% in male gender and mean age of 66-year-old were enrolled in the current study. 34 patients (43.0%) survived to hospital discharge and 20 patients (25.3%) were discharged with good neurological outcome. The median GWR of patients with good and poor outcomes in either aspect of survival or neurological function did not show significant difference. The area under the plotted receiver of characteristic curves of each GWR also did not show satisfactory predictive performance. CONCLUSIONS: The use of GWR for outcome prognosis of patients in emergency department whom progressed to circulatory failure did not show promising result.
BACKGROUND: The gray-white-matter ratio (GWR) measured on cerebral non-contrasted computed tomography (NCCT) has been reported to help the prognostication of mortality or comatose status of out-of-hospital cardiac arrest (OHCA) victims. Since the etiologies and resuscitative process differ significantly between patients with OHCA and in-hospital cardiac arrest (IHCA), the predictive ability of GWR in IHCA survivors remains unclear. METHODS: This retrospective observational study conducted in a single tertiary medical center in Taiwan enrolled all the non-traumatic IHCA adults with sustained return of spontaneous circulation (ROSC) and had received cerebral NCCT examination within 24 hours following cardiac arrest. The GWR of survivor and non-survivor as well as good and poor neurological outcome were analyzed. RESULTS: A total of 79 IHCA patients with 68.4% in male gender and mean age of 66-year-old were enrolled in the current study. 34 patients (43.0%) survived to hospital discharge and 20 patients (25.3%) were discharged with good neurological outcome. The median GWR of patients with good and poor outcomes in either aspect of survival or neurological function did not show significant difference. The area under the plotted receiver of characteristic curves of each GWR also did not show satisfactory predictive performance. CONCLUSIONS: The use of GWR for outcome prognosis of patients in emergency department whom progressed to circulatory failure did not show promising result.
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