Dataset Information

The prognostic value of gray-white-matter ratio in cardiac arrest patients treated with hypothermia.

ABSTRACT:

Background

Mild therapeutic hypothermia alters the validity of a number of parameters currently used to predict neurological outcome after cardiac arrest and resuscitation. Thus, additional parameters are needed to increase certainty of early prognosis in these patients. A promising new approach is the determination of the gray-white-matter ratio (GWR) in cranial computed tomography (CCT) obtained early after resuscitation. It is not known how GWR relates to established outcome parameters such as neuron specific enolase (NSE) or somatosensory evoked potentials (SSEP).

Methods

Cardiac arrest patients (n?=?98) treated with hypothermia were retrospectively analyzed with respect to the prognostic value of GWR, NSE and SSEP.

Results

A GWR??97 ?g/L and bilateral absent SSEP was 43%. The sensitivity increased to 53% in a multi-parameter approach predicting poor outcome using at least two of the three parameters (GWR, NSE and SSEP).

Conclusion

Our results suggest a strong association of a low GWR with poor outcome following cardiac arrest. Determination of the GWR increases the sensitivity in a multi-parameter approach for prediction of poor outcome after cardiac arrest.

SUBMITTER: Scheel M

PROVIDER: S-EPMC3636054 | biostudies-literature | 2013 Apr

REPOSITORIES: biostudies-literature

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Publications

The prognostic value of gray-white-matter ratio in cardiac arrest patients treated with hypothermia.

Scheel Michael M Storm Christian C Gentsch Andre A Nee Jens J Luckenbach Fridolin F Ploner Christoph J CJ Leithner Christoph C

Scandinavian journal of trauma, resuscitation and emergency medicine 20130408

<h4>Background</h4>Mild therapeutic hypothermia alters the validity of a number of parameters currently used to predict neurological outcome after cardiac arrest and resuscitation. Thus, additional parameters are needed to increase certainty of early prognosis in these patients. A promising new approach is the determination of the gray-white-matter ratio (GWR) in cranial computed tomography (CCT) obtained early after resuscitation. It is not known how GWR relates to established outcome parameter ...[more]

PMID: 23566292

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Project description:BackgroundThis study aimed to develop an automated method to measure the gray-white matter ratio (GWR) from brain computed tomography (CT) scans of patients with out-of-hospital cardiac arrest (OHCA) and assess its significance in predicting early-stage neurological outcomes.MethodsPatients with OHCA who underwent brain CT imaging within 12 h of return of spontaneous circulation were enrolled in this retrospective study. The primary outcome endpoint measure was a favorable neurological outcome, defined as cerebral performance category 1 or 2 at hospital discharge. We proposed an automated method comprising image registration, K-means segmentation, segmentation refinement, and GWR calculation to measure the GWR for each CT scan. The K-means segmentation and segmentation refinement was employed to refine the segmentations within regions of interest (ROIs), consequently enhancing GWR calculation accuracy through more precise segmentations.ResultsOverall, 443 patients were divided into derivation N=265, 60% and validation N=178, 40% sets, based on age and sex. The ROI Hounsfield unit values derived from the automated method showed a strong correlation with those obtained from the manual method. Regarding outcome prediction, the automated method significantly outperformed the manual method in GWR calculation (AUC 0.79 vs. 0.70) across the entire dataset. The automated method also demonstrated superior performance across sensitivity, specificity, and positive and negative predictive values using the cutoff value determined from the derivation set. Moreover, GWR was an independent predictor of outcomes in logistic regression analysis. Incorporating the GWR with other clinical and resuscitation variables significantly enhanced the performance of prediction models compared to those without the GWR.ConclusionsAutomated measurement of the GWR from non-contrast brain CT images offers valuable insights for predicting neurological outcomes during the early post-cardiac arrest period.

Dataset Information

The prognostic value of gray-white-matter ratio in cardiac arrest patients treated with hypothermia.

Background

Methods

Results

Conclusion

Publications

The prognostic value of gray-white-matter ratio in cardiac arrest patients treated with hypothermia.

Similar Datasets

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