“Pseudo-subarachnoid hemorrhage sign” on early brain computed tomography in out-of-hospital cardiac arrest survivors receiving targeted temperature management

Byung Kook Lee, Youn Jung Kim, Seung Mok Ryoo, Su Jin Kim, Dong Hun Lee, Kyung Woon Jeung, Won Young Kim

Research output: Contribution to journalArticle

7 Citations (Scopus)

Abstract

Purpose Newly updated guidelines suggest brain computed tomography for out-of-hospital cardiac arrest survivors to identify a neurologic cardiac arrest cause. We hypothesized that the “pseudo-subarachnoid hemorrhage” (p-SAH) sign in cardiac arrest survivors is associated with poor outcome. Materials and methods We retrospectively evaluated the registries of 2 tertiary hospitals, identifying 836 adult (≥18 years) patients achieving return of spontaneous circulation after out-of-hospital cardiac arrest. Among them, 398 patients with brain computed tomography within 6 hours after return of spontaneous circulation and received targeted temperature management from 2009 to 2014 were included. Clinical characteristics and outcomes of patients with and without p-SAH were compared. Results The prevalence of p-SAH sign was 8.0%. The p-SAH group more frequently had asystole as first rhythm and nonwitnessed arrest, predominantly resulting from asphyxia (56.3%). Targeted temperature management characteristics were not different between groups, although the p-SAH cohort had worse neurologic outcomes at discharge (100% vs 67.2%; P < .001). Pseudo-subarachnoid hemorrhage had 11.5% sensitivity, 100% specificity, 100% positive predictive value, and 32.8% negative predictive value for poor neurologic outcome. Conclusions Pseudo-subarachnoid hemorrhage sign might be one of the simple methods to identify poor neurologic outcome early. However, further prospective studies will be needed to clarify the clinical implication of the p-SAH sign.

Original languageEnglish
Pages (from-to)36-40
Number of pages5
JournalJournal of Critical Care
Volume40
DOIs
Publication statusPublished - 2017 Aug 1

Keywords

  • Brain computed tomography
  • Out-of-hospital cardiac arrest
  • Prognosis
  • Pseudo-subarachnoid hemorrhage
  • Targeted temperature management

ASJC Scopus subject areas

  • Critical Care and Intensive Care Medicine

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