Acute cardiac care & resuscitation
Simple approach to quantify hypoxic-ischemic brain injury severity from computed tomography imaging files after cardiac arrest
Authors' conclusion
There are differences in the distribution of HU on post-arrest CT in patients with qualitative measures of cerebral edema. Current methods to quantify cerebral edema outperform simple measures of attenuation variance on early brain CT.
Study context
- Population
- Post-cardiac arrest patients with early brain computed tomographic (CT), single centre, 2011–2020115 (10%) progressed to death by neurologic criteria (DNC)
- Participants
- 1,133 patients
- Exposure
- Novel CT density variance metrics vs grey-white ratio (GWR) for predicting DNC
- Outcome
- Prediction of progression to death by neurologic criteria (DNC)
Methodological detailssingle-centre, CTs obtained a median [IQR] of 4.2 [2.8-5.7] hours post-arrest
- Single-centre
- CTs obtained a median [IQR] of 4.2 [2.8-5.7] hours post-arrest
Main finding
As reported in the abstract
Prediction of DNC
| Group | AUC |
|---|---|
| GWR | 0.82 |
| Hounsfield units (HU) variance | 0.73 |
| Mixture model means difference | 0.56 |
AUC
GWR0.82
Hounsfield units (HU) variance0.73
Mixture model means difference0.56
Observational data: associations, not effects.
Further findings
Correlation of novel measures with GWR
- Novel measures correlated weakly with GWR
Association with sulcal or cistern effacement
- HU variance, but not difference between mixture model means, differed significantly between subjects with and without sulcal or cistern effacement
Original publication
Simple approach to quantify hypoxic-ischemic brain injury severity from computed tomography imaging files after cardiac arrest. Resuscitation. Published 15 November 2023. doi:10.
Summarised from the published abstract; every number is checked against it