World Journal of Emergency Medicine ›› 2022, Vol. 13 ›› Issue (5): 349-354.doi: 10.5847/wjem.j.1920-8642.2022.080
• Original Articles • Previous Articles Next Articles
Gan-nan Wang1, Zhong-man Zhang1, Wen Chen2, Xiao-quan Xu2, Jin-song Zhang1()
Received:
2021-11-29
Accepted:
2022-05-18
Online:
2022-08-23
Published:
2022-09-01
Contact:
Jin-song Zhang
E-mail:zhangjso@njmu.edu.cn
Gan-nan Wang, Zhong-man Zhang, Wen Chen, Xiao-quan Xu, Jin-song Zhang. Timing of brain computed tomography for predicting neurological prognosis in comatose cardiac arrest survivors: a retrospective observational study[J]. World Journal of Emergency Medicine, 2022, 13(5): 349-354.
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URL: http://wjem.com.cn/EN/10.5847/wjem.j.1920-8642.2022.080
Table 1.
Clinical characteristic of enrolled patients
Parameters | Good-outcome group (n=26) | Poor-outcome group (n=68) | P-value |
---|---|---|---|
Age, years | 52.62±16.30 | 49.72±19.93 | 0.511 |
Male | 17 (65.4) | 47 (69.1) | 0.728 |
Comorbidities | |||
Hypertension | 12 (46.2) | 27 (39.7) | 0.570 |
Diabetes | 6 (23.1) | 9 (13.2) | 0.395 |
Coronary artery disease | 2 (7.7) | 9 (13.2) | 0.697 |
Stroke | 3 (11.5) | 7 (10.3) | 0.861 |
Out-of-hospital CA | 13 (50.0) | 38 (55.9) | 0.609 |
Bystander CPR | 23 (88.5) | 44 (64.7) | 0.023 |
Cardiac etiology | 15 (57.7) | 31 (45.6) | 0.294 |
Initial shockable rhythm | 12 (46.2) | 20 (29.4) | 0.125 |
Duration of resuscitation, min | 33.0 (19.0-45.5) | 30.0 (15.5-57.5) | 0.679 |
GCS score after ROSC | 7.42±3.71 | 3.35±0.93 | <0.001 |
Length of stay in hospital, d | 17.5 (14.0-28.5) | 9.0 (3.5-25.0) | 0.010 |
CPC at hospital discharge | |||
CPC 1 | 5 | - | |
CPC 2 | 21 | - | |
CPC 3 | - | 4 | |
CPC 4 | - | 30 | |
CPC 5 | - | 34 |
Table 2.
Comparison of CT parameters between different outcome groups by early (within 24 h) and late (24 h to 7 d) CTs
Parameters | Early CT (< 24 h) | Late CT (24 h to 7 d) | ||||
---|---|---|---|---|---|---|
Good-outcome group (n=26) | Poor-outcome group (n=68) | P-value | Good-outcome group (n=26) | Poor-outcome group (n=68) | P-value | |
Density of ROI, HU | ||||||
PU | 34.1 (33.0-36.0) | 32.1 (28.2-35.9) | 0.078 | 33.5 (28.3-35.8) | 29.0 (26.0-32.0) | 0.028 |
PLIC | 27.0 (24.4-30.0) | 28.0 (22.6-29.7) | 0.880 | 25.5 (21.3-26.9) | 25.0 (22.5-28.0) | 0.388 |
GWR | ||||||
Basal ganglia | 1.22 (1.16-1.29) | 1.17 (1.10-1.23) | 0.032 | 1.28 (1.23-1.35) | 1.12 (1.08-1.18) | <0.001 |
Simplified | 1.24 (1.21-1.35) | 1.18 (1.12-1.27) | 0.052 | 1.33 (1.25-1.40) | 1.14 (1.08-1.22) | <0.001 |
pCSFV | 0.040 (0.034-0.077) | 0.048 (0.030-0.070) | 0.824 | 0.074 (0.047-0.107) | 0.038 (0.019-0.075) | 0.010 |
Table 3.
ROC-analysis on the prediction of poor neurological outcome
Prognostic factors | Cut-off value | Sensitivity (%) | Specificity (%) | AUC (95% CI) | P-value |
---|---|---|---|---|---|
GWR-basal ganglia (early CT) | 1.18 | 61.0 | 68.8 | 0.684 (0.542-0.826) | 0.032 |
1.12 | 31.7 | 100.0 | |||
GWR-basal ganglia (late CT) | 1.18 | 87.8 | 93.8 | 0.942 (0.884-0.998) | <0.001 |
1.16 | 75.6 | 100.0 | |||
GWR ratio | 1.01 | 78.0 | 75.0 | 0.761 (0.614-0.907) | 0.002 |
pCSFV (late CT) | 0.03 | 41.5 | 100.0 | 0.721 (0.591-0.851) | 0.010 |
pCSFV ratio | 0.98 | 65.9 | 93.8 | 0.788 (0.671-0.906) | 0.001 |
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