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

8 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
Pages (from-to)161-169
Number of pages9
JournalResuscitation
Volume140
DOIs
Publication statusPublished - 2019 Jul

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

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