AI Article Synopsis
- Recent studies indicate that the gray-white matter ratio (GWR) from CT scans could predict neurological outcomes in comatose cardiac arrest (CA) survivors.
- A study involving 58 CA patients assessed the GWR's association with outcomes, finding higher GWRs in patients with better recovery.
- Low GWR values, particularly from scans taken 24-72 hours post-resuscitation, were linked to poor outcomes, suggesting GWR can be a valuable tool for guiding clinical decisions.
Article Abstract
Background: Recent studies suggested that the gray-white matter ratio (GWR) determined from brain computed tomography (CT) scans may be a reliable predictor of poor neurological outcomes. The aim of study was to evaluate the association between the GWR and the outcomes in adult comatose cardiac arrest (CA) survivors in Chinese.
Methods: A total of 58 CA patients who had CT scans within 72 h of resuscitation between January 2011 and December 2015 were included in this single-center retrospective study. Gray and white matter attenuations (Hounsfield units) were measured, and the GWRs were calculated according to previous studies. The study analyzed the prognostic values of the GWRs in predicting poor outcomes (Cerebral Performance Category 3-5).
Results: The attenuation values of gray matter were significantly higher in the good outcome group than in the poor one. All GWRs were significantly higher in the good outcome group (p < 0.05). A GWR (basal ganglia) < 1.18 predicted poor outcomes with a sensitivity and specificity of 50.0% and 87.5%, respectively (p = 0.021). GWR (cerebrum) showed the best predictive performance when CT was performed within 24-72 h (p = 0.003). No significant differences were found between GWR and poor outcomes when CT was performed within the first 24 h.
Conclusion: Low GWRs which were obtained from brain CT scans in comatose CA patients after restoration of spontaneous circulation were associated with poor neurological outcomes. GWR from brain CT can be a useful parameter for prognostic prediction aiding to an optimal clinical decision process in comatose CA survivors.
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| http://dx.doi.org/10.1016/j.jcma.2018.03.003 | DOI Listing |
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