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Prognostic value of computed tomography score in patients after extracorporeal cardiopulmonary resuscitation

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Author(s)
Jeong-Am RyuYoung Hwan LeeChi Ryang ChungYang Hyun ChoKiick SungKyeongman JeonGee Young SuhTaek Kyu ParkJoo Myung LeeMinjung Kathy ChaeJeong-Ho HongSei Hee LeeHyoung Soo KimJeong Hoon Yang
Keimyung Author(s)
Hong, Jeong Ho
Department
Dept. of Neurology (신경과학)
Journal Title
Critical Care
Issued Date
2018
Volume
22
Issue
1
Keyword
Brain computed tomographyCardiopulmonary resuscitationExtracorporeal membrane oxygenation
Abstract
Background:
We evaluated whether Alberta Stroke Program Early Computed Tomography Score (ASPECTS) with some modifications could be used to predict neurological outcomes in patients after extracorporeal cardiopulmonary resuscitation (ECPR).

Methods:
This was a retrospective, multicenter, observational study of adult unconscious patients who were evaluated by brain computed tomography (CT) within 48 hours after ECPR between May 2010 and December 2016. ASPECTS, bilateral ASPECTS (ASPECTS-b), and modified ASPECTS (mASPECTS) were assessed by ROC curves to predict neurological outcomes. The primary outcome was neurological status upon hospital discharge assessed with the Cerebral Performance Categories (CPC) scale.

Results:
Among 58 unconscious patients, survival to discharge was identified in 25 (43.1%) patients. Of these 25 survivors, 19 (32.8%) had good neurological outcomes (CPC score of 1 or 2). Interrater reliability of CT scores was excellent. Intraclass correlation coefficients of ASPECTS, ASPECTS-b, and mASPECTS were 0.918 (95% CI, 0.865–0.950), 0.918 (95% CI, 0.866–0.951), and 0.915 (95% CI, 0.860–0.949), respectively. The predictive performance of mASPECTS for poor neurological outcome was better than that of ASPECTS or ASPECTS-b (C-statistic for mASPECTS vs. ASPECTS, 0.922 vs. 0.812, p = 0.004; mASPECTS vs. ASPECTS-b, 0.922 vs. 0.818, p = 0.003). A cutoff of 25 for poor neurological outcome had a sensitivity of 84.6% (95% CI, 69.5–94.1%) and a specificity of 89.5% (95% CI, 66.9–98.7%) in mASPECTS.

Conclusions:
mASPECTS might be useful for predicting neurological outcomes in patients after ECPR
Keimyung Author(s)(Kor)
홍정호
Publisher
School of Medicine (의과대학)
Citation
Jeong-Am Ryu et al. (2018). Prognostic value of computed tomography score in patients after extracorporeal cardiopulmonary resuscitation. Critical Care, 22(1), 323–323. doi: 10.1186/s13054-018-2101-2
Type
Article
ISSN
1364-8535
Source
https://ccforum.biomedcentral.com/articles/10.1186/s13054-018-2101-2
DOI
10.1186/s13054-018-2101-2
URI
https://kumel.medlib.dsmc.or.kr/handle/2015.oak/41827
Appears in Collections:
1. School of Medicine (의과대학) > Dept. of Neurology (신경과학)
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