The prognostic value of the grey-to-white matter ratio in cardiac arrest patients treated with extracorporeal membrane oxygenation.
Resuscitation
; 99: 50-5, 2016 Feb.
Article
en En
| MEDLINE
| ID: mdl-26690647
ABSTRACT
AIM:
The grey-to-white matter ratio (GWR) is a reliable predictor of the neurological outcome of out-of-hospital cardiac arrest (OHCA). However, the reliability in patients receiving extracorporeal membrane oxygenation-assisted cardiopulmonary resuscitation (ECPR) remains unknown. We evaluated the utility of the GWR in predicting neurological outcomes in ECPR-treated patients.METHODS:
This single-centre retrospective study was conducted from July 2009 to January 2014. Patients who received ECPR for OHCA were classified into two groups Cerebral performance category(CPC) 1-2 was defined as good, CPC 3-5 as poor outcome. Four GWR (GWR-AV[average], GWR-CO[cortex], GWR-BG[basal ganglia], and GWR-SI [simplified])were evaluated and compared between the groups.RESULTS:
Of 38 patients who received ECPR for OHCA, 30 patients were enrolled. Five (16.7%) had a good outcome and 25(83.3%) a poor outcome. All GWR were significantly higher in the good outcome group than in the poor outcome group. ROC curve analysis produced the following areas under the curve GWR-AV=0.920 (95% CI 0.761 to 0.987), GWR-BG=0.872 (95%CI 0.699 to 0.965), GWR-CO=0.952 (95% CI 0.806 to 0.997), and GWR-SI=0.848(95% CI 0.670 to 0.962). The cut-off value with 100% specificity for the prediction of the poor outcome was 1.23 for GWR-AV (sensitivity 76%), 1.24 for GWR-BG (sensitivity 88.0%), 1.22 for GWR-CO (sensitivity 64%), and 1.21 for GWR-SI (sensitivity 76%).CONCLUSIONS:
In ECPR, GWR of patients with poor outcome was significantly lower than that of patients with good outcome.Palabras clave
Texto completo:
1
Banco de datos:
MEDLINE
Asunto principal:
Oxigenación por Membrana Extracorpórea
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Tomografía Computarizada por Rayos X
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Paro Cardíaco Extrahospitalario
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Sustancia Gris
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Sustancia Blanca
Tipo de estudio:
Observational_studies
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Prognostic_studies
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Risk_factors_studies
Límite:
Adult
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Aged
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Female
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Humans
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Male
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Middle aged
Idioma:
En
Año:
2016
Tipo del documento:
Article