Timing of brain computed tomography for predicting neurological prognosis in comatose cardiac arrest survivors: a retrospective observational study

作     者：Gan-nan Wang Zhong-man Zhang Wen Chen Xiao-quan Xu Jin-song Zhang Gan-nan Wang;Zhong-man Zhang;Wen Chen;Xiao-quan Xu;Jin-song Zhang

作者机构：Department of Emergencythe First Affi liated Hospital of Nanjing Medical UniversityNanjing 210029China Department of Radiologythe First Affi liated Hospital of Nanjing Medical UniversityNanjing 210029China 

出 版 物：《World Journal of Emergency Medicine》 (世界急诊医学杂志（英文）)

年 卷 期：2022年第13卷第5期

页      面：349-354页

核心收录：

学科分类：100218[医学-急诊医学] 1002[医学-临床医学] 10[医学] 

基　　金：This study was supported by Ruiyi Special Fund for Emergency Medicine Research(R2019019) Postgraduate Research&Practice Innovation Program of Jiangsu Province(SJCX20_0481).Ethical approval:。 

主　　题：Cardiac arrest Brain computed tomography Cerebral edema Coma Prognosis 

摘      要：BACKGROUND:To assess the association between relevant brain computed tomography(CT)parameters at different time and neurological prognosis in adult comatose survivors after cardiac arrest(CA).METHODS:A total of 94 CA patients who underwent early and late CT scans(within 24 h and 24 h to 7 d respectively after CA)between January 2018 and April 2020 were enrolled in this retrospective study.According to the Cerebral Performance Category(CPC)score at hospital discharge,the patients were divided into either a good outcome(CPC 1-2)group or a poor-outcome group(CPC 3-5).The grey-to-white matter ratio(GWR)and the proportion of cerebrospinal fluid volume(pCSFV)were measured.In predicting poor outcomes,the prognostic performance of relevant CT parameters was evaluated,and the comparison analysis(expressed as the ratio of parameters in late CT to those in the early CT)of diff erent CT time was conducted.RESULTS:Totally 26 patients were in the good-outcome group,while 68 patients were in the poor-outcome group.The putamen density,GWR,and pCSFV in late CT were significantly lower in the poor-outcome group(P24 h after CA may be a good choice as a neuroimaging approach to evaluating prognosis.To predict neurological prognosis,comparison analysis of diff erent CT time can be used as another promising tool in comatose CA survivors.