Combination of Cerebral Computed Tomography and Simplified Cardiac Arrest Hospital Prognosis (sCAHP) Score for Predicting Neurological Recovery in Cardiac Arrest Survivors
Background: Cerebral computed tomography (CT) and various severity scoring systems have been developed for the early prediction of the neurological outcomes of cardiac arrest survivors. However, few studies have combined these approaches. Therefore, we evaluated the value of the combination of cereb...
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| Format: | Article |
| Language: | English |
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IMR Press
2023-01-01
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| Series: | Reviews in Cardiovascular Medicine |
| Subjects: | |
| Online Access: | https://www.imrpress.com/journal/RCM/24/1/10.31083/j.rcm2401025 |
| _version_ | 1797937810956615680 |
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| author | Sih-Shiang Huang Yu-Tzu Tien Hsin-Yu Lee Hooi-Nee Ong Chien-Hua Huang Wei-Ting Chen Wen-Jone Chen Wei-Tien Chang Min-Shan Tsai |
| author_facet | Sih-Shiang Huang Yu-Tzu Tien Hsin-Yu Lee Hooi-Nee Ong Chien-Hua Huang Wei-Ting Chen Wen-Jone Chen Wei-Tien Chang Min-Shan Tsai |
| author_sort | Sih-Shiang Huang |
| collection | DOAJ |
| description | Background: Cerebral computed tomography (CT) and various severity scoring systems have been developed for the early prediction of the neurological outcomes of cardiac arrest survivors. However, few studies have combined these approaches. Therefore, we evaluated the value of the combination of cerebral CT and severity score for neuroprognostication. Methods: This single-center, retrospective observational study included consecutive patients surviving nontraumatic cardiac arrest (January 2016 and December 2020). Gray-to-white ratio (GWR), third and fourth ventricle characteristics, and medial temporal lobe atrophy scores were evaluated on noncontrast cerebral CT. Simplified cardiac arrest hospital prognosis (sCAHP) score was calculated for severity assessment. The associations between the CT characteristics, sCAHP score and neurological outcomes were analyzed. Results: This study enrolled 559 patients. Of them, 194 (34.7%) were discharged with favorable neurological outcomes. Patients with favorable neurological outcome had a higher GWR (1.37 vs 1.25, p < 0.001), area of fourth ventricle (461 vs 413 mm2, p < 0.001), anteroposterior diameter of fourth ventricle (0.95 vs 0.86 cm , p < 0.001) and a lower sCAHP score (146 vs 190, p < 0.001) than those with poor recovery. Patients with higher sCAHP score had lower GWR (p trend < 0.001), area of fourth ventricle (p trend = 0.019) and anteroposterior diameter of fourth ventricle (p trend = 0.014). The predictive ability by using area under receiver operating characteristic curve (AUC) for the combination of sCAHP score and GWR was significantly higher than that calculated for sCAHP (0.86 vs 0.76, p < 0.001) or GWR (0.86 vs 0.81, p = 0.001) alone. Conclusions: The combination of GWR and sCAHP score can be used to effectively predict the neurological outcomes of cardiac arrest survivors and thus ensure timely intervention for those at high risk of poor recovery. |
| first_indexed | 2024-04-10T18:50:05Z |
| format | Article |
| id | doaj.art-24bde6ed7dab47e685da91b99c808280 |
| institution | Directory Open Access Journal |
| issn | 1530-6550 |
| language | English |
| last_indexed | 2024-04-10T18:50:05Z |
| publishDate | 2023-01-01 |
| publisher | IMR Press |
| record_format | Article |
| series | Reviews in Cardiovascular Medicine |
| spelling | doaj.art-24bde6ed7dab47e685da91b99c8082802023-02-01T07:32:12ZengIMR PressReviews in Cardiovascular Medicine1530-65502023-01-012412510.31083/j.rcm2401025S1530-6550(22)00799-2Combination of Cerebral Computed Tomography and Simplified Cardiac Arrest Hospital Prognosis (sCAHP) Score for Predicting Neurological Recovery in Cardiac Arrest SurvivorsSih-Shiang Huang0Yu-Tzu Tien1Hsin-Yu Lee2Hooi-Nee Ong3Chien-Hua Huang4Wei-Ting Chen5Wen-Jone Chen6Wei-Tien Chang7Min-Shan Tsai8Department of Emergency Medicine, National Taiwan University Medical College and Hospital, 100 Taipei, TaiwanDepartment of Emergency Medicine, National Taiwan University Medical College and Hospital, 100 Taipei, TaiwanDepartment of Emergency Medicine, National Taiwan University Medical College and Hospital, 100 Taipei, TaiwanDepartment of Emergency Medicine, National Taiwan University Medical College and Hospital, 100 Taipei, TaiwanDepartment of Emergency Medicine, National Taiwan University Medical College and Hospital, 100 Taipei, TaiwanDepartment of Emergency Medicine, National Taiwan University Medical College and Hospital, 100 Taipei, TaiwanDepartment of Emergency Medicine, National Taiwan University Medical College and Hospital, 100 Taipei, TaiwanDepartment of Emergency Medicine, National Taiwan University Medical College and Hospital, 100 Taipei, TaiwanDepartment of Emergency Medicine, National Taiwan University Medical College and Hospital, 100 Taipei, TaiwanBackground: Cerebral computed tomography (CT) and various severity scoring systems have been developed for the early prediction of the neurological outcomes of cardiac arrest survivors. However, few studies have combined these approaches. Therefore, we evaluated the value of the combination of cerebral CT and severity score for neuroprognostication. Methods: This single-center, retrospective observational study included consecutive patients surviving nontraumatic cardiac arrest (January 2016 and December 2020). Gray-to-white ratio (GWR), third and fourth ventricle characteristics, and medial temporal lobe atrophy scores were evaluated on noncontrast cerebral CT. Simplified cardiac arrest hospital prognosis (sCAHP) score was calculated for severity assessment. The associations between the CT characteristics, sCAHP score and neurological outcomes were analyzed. Results: This study enrolled 559 patients. Of them, 194 (34.7%) were discharged with favorable neurological outcomes. Patients with favorable neurological outcome had a higher GWR (1.37 vs 1.25, p < 0.001), area of fourth ventricle (461 vs 413 mm2, p < 0.001), anteroposterior diameter of fourth ventricle (0.95 vs 0.86 cm , p < 0.001) and a lower sCAHP score (146 vs 190, p < 0.001) than those with poor recovery. Patients with higher sCAHP score had lower GWR (p trend < 0.001), area of fourth ventricle (p trend = 0.019) and anteroposterior diameter of fourth ventricle (p trend = 0.014). The predictive ability by using area under receiver operating characteristic curve (AUC) for the combination of sCAHP score and GWR was significantly higher than that calculated for sCAHP (0.86 vs 0.76, p < 0.001) or GWR (0.86 vs 0.81, p = 0.001) alone. Conclusions: The combination of GWR and sCAHP score can be used to effectively predict the neurological outcomes of cardiac arrest survivors and thus ensure timely intervention for those at high risk of poor recovery.https://www.imrpress.com/journal/RCM/24/1/10.31083/j.rcm2401025severity scorecardiac arrestneuroprognosticationgray-to-white ratiocerebral ct |
| spellingShingle | Sih-Shiang Huang Yu-Tzu Tien Hsin-Yu Lee Hooi-Nee Ong Chien-Hua Huang Wei-Ting Chen Wen-Jone Chen Wei-Tien Chang Min-Shan Tsai Combination of Cerebral Computed Tomography and Simplified Cardiac Arrest Hospital Prognosis (sCAHP) Score for Predicting Neurological Recovery in Cardiac Arrest Survivors Reviews in Cardiovascular Medicine severity score cardiac arrest neuroprognostication gray-to-white ratio cerebral ct |
| title | Combination of Cerebral Computed Tomography and Simplified Cardiac Arrest Hospital Prognosis (sCAHP) Score for Predicting Neurological Recovery in Cardiac Arrest Survivors |
| title_full | Combination of Cerebral Computed Tomography and Simplified Cardiac Arrest Hospital Prognosis (sCAHP) Score for Predicting Neurological Recovery in Cardiac Arrest Survivors |
| title_fullStr | Combination of Cerebral Computed Tomography and Simplified Cardiac Arrest Hospital Prognosis (sCAHP) Score for Predicting Neurological Recovery in Cardiac Arrest Survivors |
| title_full_unstemmed | Combination of Cerebral Computed Tomography and Simplified Cardiac Arrest Hospital Prognosis (sCAHP) Score for Predicting Neurological Recovery in Cardiac Arrest Survivors |
| title_short | Combination of Cerebral Computed Tomography and Simplified Cardiac Arrest Hospital Prognosis (sCAHP) Score for Predicting Neurological Recovery in Cardiac Arrest Survivors |
| title_sort | combination of cerebral computed tomography and simplified cardiac arrest hospital prognosis scahp score for predicting neurological recovery in cardiac arrest survivors |
| topic | severity score cardiac arrest neuroprognostication gray-to-white ratio cerebral ct |
| url | https://www.imrpress.com/journal/RCM/24/1/10.31083/j.rcm2401025 |
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