Standardised and automated assessment of head computed tomography reliably predicts poor functional outcome after cardiac arrest : a prospective multicentre study

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Standardised and automated assessment of head computed tomography reliably predicts poor functional outcome after cardiac arrest : a prospective multicentre study

Lang, Margareta (författare): Lund University,Lunds universitet,Kliniska Vetenskaper, Helsingborg,Sektion II,Institutionen för kliniska vetenskaper, Lund,Medicinska fakulteten,Clinical Sciences, Helsingborg,Section II,Department of Clinical Sciences, Lund,Faculty of Medicine,Helsingborg Hospital,Lund Univ, Sweden; Helsingborg Hosp, Sweden

Kenda, Martin (författare): Charité - University Medicine Berlin,Berlin Institute of Health (BIH),Charite Univ Med Berlin, Germany; Freie Univ, Germany; Humboldt Univ, Germany

Scheel, Michael (författare): Charité - University Medicine Berlin,Charite Univ Med Berlin, Germany

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Martola, Juha (författare): University of Helsinki,Univ Helsinki, Finland

Wheeler, Matthew (författare): University Hospital of Wales,Univ Hosp Wales, Wales

Owen, Stephanie (författare): University Hospital of Wales,Univ Hosp Wales, Wales; Vale Univ Hlth Board, Wales

Johnsson, Mikael (författare): Helsingborg Hospital,Helsingborg Hosp, Sweden; Vale Univ Hlth Board, Wales

Annborn, Martin (författare): Lund University,Lunds universitet,Kliniska Vetenskaper, Helsingborg,Sektion II,Institutionen för kliniska vetenskaper, Lund,Medicinska fakulteten,Clinical Sciences, Helsingborg,Section II,Department of Clinical Sciences, Lund,Faculty of Medicine,Helsingborg Hospital,Lund Univ, Sweden; Helsingborg Hosp, Sweden

Dankiewicz, Josef (författare): Lund University,Lunds universitet,Kardiologi,Sektion II,Institutionen för kliniska vetenskaper, Lund,Medicinska fakulteten,Cardiology,Section II,Department of Clinical Sciences, Lund,Faculty of Medicine,Skåne University Hospital,Lund Univ, Sweden; Skane Univ Hosp, Sweden

Deye, Nicolas (författare): Lariboisière Hospital,Lariboisiere Univ Hosp, France

Düring, Joachim (författare): Lund University,Lunds universitet,Anestesiologi och intensivvård,Sektion II,Institutionen för kliniska vetenskaper, Lund,Medicinska fakulteten,Anesthesiology and Intensive Care,Section II,Department of Clinical Sciences, Lund,Faculty of Medicine,Skåne University Hospital,Lund Univ, Sweden; Skane Univ Hosp, Sweden

Friberg, Hans (författare): Lund University,Lunds universitet,Anestesiologi och intensivvård,Sektion II,Institutionen för kliniska vetenskaper, Lund,Medicinska fakulteten,Centrum för hjärtstopp,Forskargrupper vid Lunds universitet,SWECRIT,Anesthesiology and Intensive Care,Section II,Department of Clinical Sciences, Lund,Faculty of Medicine,Center for cardiac arrest,Lund University Research Groups,Skåne University Hospital,Lund Univ, Sweden; Skane Univ Hosp, Sweden

Halliday, Thomas (författare): Linköping University Hospital,Region Östergötland, ANOPIVA US

Jakobsen, Janus Christian (författare): Copenhagen University Hospital,University of Southern Denmark,Univ Southern Denmark, Denmark; Rigshosp, Denmark

Lascarrou, Jean Baptiste (författare): Nantes Univ, France

Levin, Helena (författare): Lund University,Lunds universitet,Anestesiologi och intensivvård,Sektion II,Institutionen för kliniska vetenskaper, Lund,Medicinska fakulteten,Centrum för hjärtstopp,Forskargrupper vid Lunds universitet,Anesthesiology and Intensive Care,Section II,Department of Clinical Sciences, Lund,Faculty of Medicine,Center for cardiac arrest,Lund University Research Groups,Skåne University Hospital,Lund Univ, Sweden; Skane Univ Hosp, Sweden

Lilja, Gisela (författare): Lund University,Lunds universitet,Neurologi, Lund,Sektion IV,Institutionen för kliniska vetenskaper, Lund,Medicinska fakulteten,Centrum för hjärtstopp,Forskargrupper vid Lunds universitet,Brain Injury After Cardiac Arrest,Neurology, Lund,Section IV,Department of Clinical Sciences, Lund,Faculty of Medicine,Center for cardiac arrest,Lund University Research Groups,Skåne University Hospital,Lund Univ, Sweden; Skane Univ Hosp, Sweden

Lybeck, Anna (författare): Lund University,Lunds universitet,Anestesiologi och intensivvård,Sektion II,Institutionen för kliniska vetenskaper, Lund,Medicinska fakulteten,Centrum för hjärtstopp,Forskargrupper vid Lunds universitet,Anesthesiology and Intensive Care,Section II,Department of Clinical Sciences, Lund,Faculty of Medicine,Center for cardiac arrest,Lund University Research Groups,Skåne University Hospital,Lund Univ, Sweden; Skane Univ Hosp, Sweden

McGuigan, Peter (författare): Royal Victoria Hospital, Belfast,Queen's University Belfast,Royal Victoria Hosp, North Ireland; Queens Univ Belfast, North Ireland

Rylander, Christian (författare): Uppsala University,Uppsala Univ, Sweden

Sem, Victoria (författare): Karlstad Hospital,Cent Hosp Karlstad, Sweden

Thomas, Matthew (författare): University Hospitals Bristol NHS Foundation Trust,Univ Hosp Bristol & Weston, England

Ullén, Susann (författare): Skåne University Hospital,Skane Univ Hosp, Sweden

Undén, Johan (författare): Lund University,Lunds universitet,Anestesiologi och intensivvård,Forskargrupper vid Lunds universitet,Anaesthesiology and Intensive Care Medicine,Lund University Research Groups,Halmstad County Hospital,Lund Univ, Sweden; Hallands Hosp Halmstad, Sweden

Wise, Matt P. (författare): University Hospital of Wales,Univ Hosp Wales, Wales

Cronberg, Tobias (författare): Lund University,Lunds universitet,Neurologi, Lund,Sektion IV,Institutionen för kliniska vetenskaper, Lund,Medicinska fakulteten,Centrum för hjärtstopp,Forskargrupper vid Lunds universitet,Brain Injury After Cardiac Arrest,Neurology, Lund,Section IV,Department of Clinical Sciences, Lund,Faculty of Medicine,Center for cardiac arrest,Lund University Research Groups,Skåne University Hospital,Lund Univ, Sweden; Skane Univ Hosp, Sweden

Wassélius, Johan (författare): Lund University,Lunds universitet,Diagnostisk radiologi, Lund,Sektion V,Institutionen för kliniska vetenskaper, Lund,Medicinska fakulteten,Neuroradiologi,Forskargrupper vid Lunds universitet,Stroke Imaging Research group,Diagnostic Radiology, (Lund),Section V,Department of Clinical Sciences, Lund,Faculty of Medicine,Neuroradiology,Lund University Research Groups,Skåne University Hospital,Lund Univ, Sweden; Skane Univ Hosp, Sweden

Nielsen, Niklas (författare): Lund University,Lunds universitet,Anestesiologi och intensivvård,Sektion II,Institutionen för kliniska vetenskaper, Lund,Medicinska fakulteten,Kliniska Vetenskaper, Helsingborg,Institutionen för kliniska vetenskaper, Lund,Centrum för hjärtstopp,Forskargrupper vid Lunds universitet,SEBRA Sepsis and Bacterial Resistance Alliance,Anesthesiology and Intensive Care,Section II,Department of Clinical Sciences, Lund,Faculty of Medicine,Clinical Sciences, Helsingborg,Department of Clinical Sciences, Lund,Center for cardiac arrest,Lund University Research Groups,Helsingborg Hospital,Lund Univ, Sweden; Helsingborg Hosp, Sweden

Leithner, Christoph (författare): Charité - University Medicine Berlin,Charite Univ Med Berlin, Germany; Freie Univ, Germany; Humboldt Univ, Germany

Moseby-Knappe, Marion (författare): Lund University,Lunds universitet,Neurologi, Lund,Sektion IV,Institutionen för kliniska vetenskaper, Lund,Medicinska fakulteten,Brain Injury After Cardiac Arrest,Forskargrupper vid Lunds universitet,Neurologiska skador vid akut aortadissektion typ A,Neurology, Lund,Section IV,Department of Clinical Sciences, Lund,Faculty of Medicine,Lund University Research Groups,Neurological injury in acute type A aortic dissection,Skåne University Hospital,Lund Univ, Sweden; Skane Univ Hosp, Sweden

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SPRINGER, 2024
2024
Engelska 12 s.
Ingår i: Intensive Care Medicine. - : SPRINGER. - 0342-4642 .- 1432-1238. ; 50:7, s. 1096-1107

Relaterad länk:: http://dx.doi.org/10... (free); visa fler...; https://lup.lub.lu.s...; https://doi.org/10.1...; https://urn.kb.se/re...; visa färre...

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Purpose: Application of standardised and automated assessments of head computed tomography (CT) for neuroprognostication after out-of-hospital cardiac arrest. Methods: Prospective, international, multicentre, observational study within the Targeted Hypothermia versus Targeted Normothermia after out-of-hospital cardiac arrest (TTM2) trial. Routine CTs from adult unconscious patients obtained > 48 h ≤ 7 days post-arrest were assessed qualitatively and quantitatively by seven international raters blinded to clinical information using a pre-published protocol. Grey–white-matter ratio (GWR) was calculated from four (GWR-4) and eight (GWR-8) regions of interest manually placed at the basal ganglia level. Additionally, GWR was obtained using an automated atlas-based approach. Prognostic accuracies for prediction of poor functional outcome (modified Rankin Scale 4–6) for the qualitative assessment and for the pre-defined GWR cutoff < 1.10 were calculated. Results: 140 unconscious patients were included; median age was 68 years (interquartile range [IQR] 59–76), 76% were male, and 75% had poor outcome. Standardised qualitative assessment and all GWR models predicted poor outcome with 100% specificity (95% confidence interval [CI] 90–100). Sensitivity in median was 37% for the standardised qualitative assessment, 39% for GWR-8, 30% for GWR-4 and 41% for automated GWR. GWR-8 was superior to GWR-4 regarding prognostic accuracies, intra- and interrater agreement. Overall prognostic accuracy for automated GWR (area under the curve [AUC] 0.84, 95% CI 0.77–0.91) did not significantly differ from manually obtained GWR. Conclusion: Standardised qualitative and quantitative assessments of CT are reliable and feasible methods to predict poor functional outcome after cardiac arrest. Automated GWR has the potential to make CT quantification for neuroprognostication accessible to all centres treating cardiac arrest patients.

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Standardised and automated assessment of head computed tomography reliably predicts poor functional outcome after cardiac arrest : a prospective multicentre study

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