Acute cardiac care & resuscitation

Time-dependent association of grey-white ratio on early brain computed tomography (CT) predicting outcomes after cardiac arrest at hospital discharge

ResuscitationPublished Retrospective cohort study

Authors' conclusion

The sensitivity and FPR of early GWR predicting in-hospital mortality and DNC after resuscitation from cardiac arrest varies over the initial post-arrest period.

Study context

Population
Patients resuscitated from cardiac arrest, unresponsive to verbal commands, with brain CT within 24 hours, 2010–2023mean age 59 (SD 16) years
Participants
2,204 patients
Exposure
GWR <1.10 and <1.20 on brain CT by time from arrest to CT
Outcome
Sensitivity and false positive rate of GWR predicting in-hospital mortality and death by neurologic criteria (DNC)
Follow-up
First 24 hours post-arrest
Methodological detailssingle-centre
  • Single-centre

Main finding

As reported in the abstract

In-hospital mortality

Sensitivity of GWR <1.10 and GWR <1.20 increased over the first four hours post-arrest, maximum after five hours

25%

False positive rates at all time points

<5%

Observational data: associations, not effects.

Further findings

Death by neurologic criteria (DNC)

Similar temporal trends, although absolute sensitivity and false positive rate (FPR) varied

Overall outcomes

Died in hospital
1651 (75%)
Progressed to DNC
248 (11%)

Original publication

Time-dependent association of grey-white ratio on early brain CT predicting outcomes after cardiac arrest at hospital discharge. Resuscitation. Published 26 November 2024. doi:10.1016/j.resuscitation.2024.110440

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