Better prognostic value with combined optic nerve sheath diameter and grey-to-white matter ratio on initial brain computed tomography in post-cardiac arrest patients

详细信息    查看全文

• 作者：Minjung Kathy Chae¹ ; Eunsil Ko¹ ; Jeong Hoon Lee ; Tae Rim Lee ; Hee Yoon ; Sung Yeon Hwang ; Won Chul Cha ; Tae Gun Shin ; Min Seob Sim ; ^{coldco2@naver.com" class="auth_mail" title="E-mail the corresponding author} ; Ik Joon Jo ; Keun Jeong Song ; Joong Eui Rhee ; Yeon Kwon Jeong
• 关键词：Cardiac arrest ; Targeted temperature management ; Brain computed tomography ; Grey-to-white matter ratio ; Optic nerve sheath diameter
• 刊名：Resuscitation
• 出版年：2016
• 出版时间：July 2016
• 年：2016
• 卷：104
• 期：Complete
• 页码：40-45
• 全文大小：733 K

文摘

We aimed to evaluate the prognostic value of optic nerve sheath diameter (ONSD) and grey-to-white matter (GWR) either alone or in combination in patients treated with targeted temperature management (TTM) after cardiac arrest (CA).

Methods

We conducted a retrospective single centre study of post cardiac arrest patients treated with TTM. ONSD and GWR on brain computed tomography (CT) was measured by two emergency physicians. We analysed the prognostic performance and cut offs of GWR and ONSD, singly and in combination in predicting poor neurologic outcome (CPC 3–5).

Results

Of the 119 patients studied, 74 patients showed poor outcome. The combination of ONSD and GWR significantly (p = 0.002) improved prognostic performance (AUROC 0.67, 95% CI: 0.58–0.76, p < 0.001) in predicting poor neurologic outcomes rather than each ONSD (AUROC 0.59, 95% CI: 0.50–0.68, p = 0.08) or GWR (AUROC 0.65, 95% CI: 0.56–0.74, p = 0.002) alone. A combined cut off of ‘GWR and ONSD (1.16 and 4.9)’ and ‘GWR or ONSD (1.13 or 6.5)’ improved the sensitivity for predicting poor outcome while maintaining high specificity compared to GWR alone.

Conclusion

The combination of ONSD and GWR yielded improved prognostic value for predicting poor neurologic outcomes in post cardiac arrest patients treated with TTM.