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

被引：47

作者：

Chae, Minjung Kathy ^{[1
]}

Ko, Eunsil ^{[1
]}

Lee, Jeong Hoon ^{[1
]}

Lee, Tae Rim ^{[1
]}

Yoon, Hee ^{[1
]}

Hwang, Sung Yeon ^{[1
]}

Cha, Won Chul ^{[1
]}

Shin, Tae Gun ^{[1
]}

Sim, Min Seob ^{[1
]}

Jo, Ik Joon ^{[1
]}

Song, Keun Jeong ^{[1
]}

Rhee, Joong Eui ^{[1
]}

Jeong, Yeon Kwon ^{[1
]}

机构：

[1] Sungkyunkwan Univ, Dept Emergency Med, Samsung Med Ctr, Sch Med, 135-710 Ilwon Dong 50, Seoul, South Korea

来源：

RESUSCITATION | 2016年 / 104卷

关键词：

Cardiac arrest; Targeted temperature management; Brain computed tomography; Grey-to-white matter ratio; Optic nerve sheath diameter; NEURON-SPECIFIC ENOLASE; QUALITY-OF-LIFE; THERAPEUTIC HYPOTHERMIA; COMATOSE SURVIVORS; EARLY PREDICTOR; RESUSCITATION; ASSOCIATION; INJURY; EDEMA; SCAN;

D O I：

10.1016/j.resuscitation.2016.04.001

中图分类号：

R4 [临床医学];

学科分类号：

1002 ; 100602 ;

摘要：

Aim: 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. (C) 2016 Elsevier Ireland Ltd. All rights reserved.

引用

页码：40 / 45

页数：6

共 26 条

[1] Treatment of comatose survivors of out-of-hospital cardiac arrest with induced hypothermia [J].