Early findings on brain computed tomography and the prognosis of post-cardiac arrest syndrome: Application of the score for stroke patients
| Autor: | Makoto Hashizume, Hiroshi Sugimori, Koji Yamashita, Tomoo Kanna, Akinori Zaitsu, Takahiro Kuwashiro, Takashi Yoshiura |
|---|---|
| Rok vydání: | 2012 |
| Předmět: |
Adult
Male medicine.medical_specialty Adolescent Emergency Nursing Severity of Illness Index law.invention Young Adult law Internal medicine Linear regression Severity of illness medicine Humans Young adult Stroke Aged Aged 80 and over Receiver operating characteristic business.industry Persistent Vegetative State Area under the curve Brain Odds ratio Middle Aged Prognosis medicine.disease Intensive care unit Heart Arrest Surgery Intensive Care Units ROC Curve Linear Models Emergency Medicine Female Tomography X-Ray Computed Cardiology and Cardiovascular Medicine business |
| Zdroj: | Resuscitation. 83:848-854 |
| ISSN: | 0300-9572 |
| Popis: | Aim To examine whether early findings of the brain computed tomography (CT) evaluated by the modified Alberta stroke programme early CT (m-ASPECT) score is useful for determining the prognosis of post-cardiac arrest syndrome (PCAS) patients or not. Materials From 2003 through 2010, 149 consecutive PCAS patients: (1) with various aetiologies but neither from haemorrhagic stroke nor trauma, (2) who were 15 years old or older and (3) whose brain CT was available were admitted to our intensive care unit. Early findings on all of their CT images were rated with the m-ASPECT scoring system by three raters, and an inter-rater comparison was conducted. Next, the images within 24 h from arrest were collected from 133 patients (89 males, age 60.2 ± 17.6 years), and a relation of the scores with outcome at day 30 of the patients was analysed. Results According to the inter-rater comparison based on a linear regression analysis, agreement between the raters was good (correlation coefficient 0.76–0.88). A receiver operating curve analysis revealed that the m-ASPECT scores within 24 h were a good predictor of poor outcome (dead or vegetative state) with an area under the curve of 0.905. An m-ASPECT score ≤13 was 100% predictive of a poor outcome, with a negative predictive value of 0.57. The m-ASPECT score was the best predictor of poor outcome (odds ratio 45.62) among various factors including cause or duration of arrest. Conclusion The m-APSECT score evaluated within 24 h from arrest was found to be the most predictive factor for outcome at day 30. |
| Databáze: | OpenAIRE |
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