Grey–white matter ratio measured using early unenhanced brain computed tomography shows no correlation with neurological outcomes in patients undergoing targeted temperature management after cardiac arrest

Jun Young Hong, Dong Hoon Lee, Je Hyeok Oh, Sun Hwa Lee, Yoon Hee Choi, Soo Hyun Kim, Jin Hong Min, Su Jin Kim, Yoo Seok Park

Research output: Contribution to journalArticle

2 Citations (Scopus)

Abstract

Aim: This study evaluated whether the grey–white matter ratio (GWR) assessed via early brain computed tomography (CT) within 2 h after the return of spontaneous circulation (ROSC) following cardiac arrest is associated with poor neurological outcomes after 6 months in post-cardiac arrest patients treated with targeted temperature management (TTM). Methods: This study used data from the Korean Hypothermia Network prospective registry obtained from November 2015 to October 2017 to assess patients with out-of-hospital cardiac arrest (OHCA) who underwent brain CT within 2 h following the ROSC. The primary endpoint was the neurological outcome 6 months post-cardiac arrest (cerebral performance category; CPC). The GWR was measured using early brain CT images. The subgroup analysis examined the difference in GWRs obtained from early and repeated brain CT. Results: Five-hundred-twelve patients were enrolled. Good (CPC 1–2) and poor (CPC 3–5) neurological outcomes were observed in 162 (31.6%) and 350 (68.4%) patients, respectively. The multivariate logistic regression analysis revealed that the GWR measured using early brain CT was a statistically nonsignificant predictor of poor neurologic outcomes (p = 0.727). In patients with poor outcomes, the mean GWR obtained from early and repeated CT images were 1.171 ± 0.058 and 1.091 ± 0.133, respectively (p < 0.001); there was no statistically significant difference between the GWRs in patients with good outcomes. Conclusion: The GWR assessed via early brain CT alone is not an independent factor predictive of poor neurologic outcomes but could be useful when used with repeated CT data.

Original languageEnglish
JournalResuscitation
DOIs
Publication statusPublished - 2019 Jan 1

Fingerprint

Heart Arrest
Tomography
Temperature
Brain
Nervous System
Out-of-Hospital Cardiac Arrest
Hypothermia
Registries
Logistic Models
Regression Analysis

Keywords

  • Cardiac arrest
  • Grey–white matter ratio
  • Neurological outcome
  • Post-cardiac arrest syndrome
  • Prognostic factor
  • Targeted temperature management

ASJC Scopus subject areas

  • Emergency Medicine
  • Emergency
  • Cardiology and Cardiovascular Medicine

Cite this

Grey–white matter ratio measured using early unenhanced brain computed tomography shows no correlation with neurological outcomes in patients undergoing targeted temperature management after cardiac arrest. / Hong, Jun Young; Lee, Dong Hoon; Oh, Je Hyeok; Lee, Sun Hwa; Choi, Yoon Hee; Kim, Soo Hyun; Min, Jin Hong; Kim, Su Jin; Park, Yoo Seok.

In: Resuscitation, 01.01.2019.

Research output: Contribution to journalArticle

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title = "Grey–white matter ratio measured using early unenhanced brain computed tomography shows no correlation with neurological outcomes in patients undergoing targeted temperature management after cardiac arrest",
abstract = "Aim: This study evaluated whether the grey–white matter ratio (GWR) assessed via early brain computed tomography (CT) within 2 h after the return of spontaneous circulation (ROSC) following cardiac arrest is associated with poor neurological outcomes after 6 months in post-cardiac arrest patients treated with targeted temperature management (TTM). Methods: This study used data from the Korean Hypothermia Network prospective registry obtained from November 2015 to October 2017 to assess patients with out-of-hospital cardiac arrest (OHCA) who underwent brain CT within 2 h following the ROSC. The primary endpoint was the neurological outcome 6 months post-cardiac arrest (cerebral performance category; CPC). The GWR was measured using early brain CT images. The subgroup analysis examined the difference in GWRs obtained from early and repeated brain CT. Results: Five-hundred-twelve patients were enrolled. Good (CPC 1–2) and poor (CPC 3–5) neurological outcomes were observed in 162 (31.6{\%}) and 350 (68.4{\%}) patients, respectively. The multivariate logistic regression analysis revealed that the GWR measured using early brain CT was a statistically nonsignificant predictor of poor neurologic outcomes (p = 0.727). In patients with poor outcomes, the mean GWR obtained from early and repeated CT images were 1.171 ± 0.058 and 1.091 ± 0.133, respectively (p < 0.001); there was no statistically significant difference between the GWRs in patients with good outcomes. Conclusion: The GWR assessed via early brain CT alone is not an independent factor predictive of poor neurologic outcomes but could be useful when used with repeated CT data.",
keywords = "Cardiac arrest, Grey–white matter ratio, Neurological outcome, Post-cardiac arrest syndrome, Prognostic factor, Targeted temperature management",
author = "Hong, {Jun Young} and Lee, {Dong Hoon} and Oh, {Je Hyeok} and Lee, {Sun Hwa} and Choi, {Yoon Hee} and Kim, {Soo Hyun} and Min, {Jin Hong} and Kim, {Su Jin} and Park, {Yoo Seok}",
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AU - Hong, Jun Young

AU - Lee, Dong Hoon

AU - Oh, Je Hyeok

AU - Lee, Sun Hwa

AU - Choi, Yoon Hee

AU - Kim, Soo Hyun

AU - Min, Jin Hong

AU - Kim, Su Jin

AU - Park, Yoo Seok

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N2 - Aim: This study evaluated whether the grey–white matter ratio (GWR) assessed via early brain computed tomography (CT) within 2 h after the return of spontaneous circulation (ROSC) following cardiac arrest is associated with poor neurological outcomes after 6 months in post-cardiac arrest patients treated with targeted temperature management (TTM). Methods: This study used data from the Korean Hypothermia Network prospective registry obtained from November 2015 to October 2017 to assess patients with out-of-hospital cardiac arrest (OHCA) who underwent brain CT within 2 h following the ROSC. The primary endpoint was the neurological outcome 6 months post-cardiac arrest (cerebral performance category; CPC). The GWR was measured using early brain CT images. The subgroup analysis examined the difference in GWRs obtained from early and repeated brain CT. Results: Five-hundred-twelve patients were enrolled. Good (CPC 1–2) and poor (CPC 3–5) neurological outcomes were observed in 162 (31.6%) and 350 (68.4%) patients, respectively. The multivariate logistic regression analysis revealed that the GWR measured using early brain CT was a statistically nonsignificant predictor of poor neurologic outcomes (p = 0.727). In patients with poor outcomes, the mean GWR obtained from early and repeated CT images were 1.171 ± 0.058 and 1.091 ± 0.133, respectively (p < 0.001); there was no statistically significant difference between the GWRs in patients with good outcomes. Conclusion: The GWR assessed via early brain CT alone is not an independent factor predictive of poor neurologic outcomes but could be useful when used with repeated CT data.

AB - Aim: This study evaluated whether the grey–white matter ratio (GWR) assessed via early brain computed tomography (CT) within 2 h after the return of spontaneous circulation (ROSC) following cardiac arrest is associated with poor neurological outcomes after 6 months in post-cardiac arrest patients treated with targeted temperature management (TTM). Methods: This study used data from the Korean Hypothermia Network prospective registry obtained from November 2015 to October 2017 to assess patients with out-of-hospital cardiac arrest (OHCA) who underwent brain CT within 2 h following the ROSC. The primary endpoint was the neurological outcome 6 months post-cardiac arrest (cerebral performance category; CPC). The GWR was measured using early brain CT images. The subgroup analysis examined the difference in GWRs obtained from early and repeated brain CT. Results: Five-hundred-twelve patients were enrolled. Good (CPC 1–2) and poor (CPC 3–5) neurological outcomes were observed in 162 (31.6%) and 350 (68.4%) patients, respectively. The multivariate logistic regression analysis revealed that the GWR measured using early brain CT was a statistically nonsignificant predictor of poor neurologic outcomes (p = 0.727). In patients with poor outcomes, the mean GWR obtained from early and repeated CT images were 1.171 ± 0.058 and 1.091 ± 0.133, respectively (p < 0.001); there was no statistically significant difference between the GWRs in patients with good outcomes. Conclusion: The GWR assessed via early brain CT alone is not an independent factor predictive of poor neurologic outcomes but could be useful when used with repeated CT data.

KW - Cardiac arrest

KW - Grey–white matter ratio

KW - Neurological outcome

KW - Post-cardiac arrest syndrome

KW - Prognostic factor

KW - Targeted temperature management

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