Predicting Outcome With Diffusion-Weighted Imaging in Cardiac Arrest Patients Receiving Hypothermia Therapy: Multicenter Retrospective Cohort Study
DC Field | Value | Language |
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dc.contributor.author | Ryoo, Seung Mok | - |
dc.contributor.author | Jeon, Sang-Beom | - |
dc.contributor.author | Sohn, Chang Hwan | - |
dc.contributor.author | Ahn, Shin | - |
dc.contributor.author | Han, Chul | - |
dc.contributor.author | Lee, Byung Kook | - |
dc.contributor.author | Lee, Dong Hoon | - |
dc.contributor.author | Kim, Soo Hyun | - |
dc.contributor.author | Donnino, Michael W. | - |
dc.contributor.author | Kim, Won Young | - |
dc.date.available | 2019-03-08T16:37:27Z | - |
dc.date.issued | 2015-11 | - |
dc.identifier.issn | 0090-3493 | - |
dc.identifier.issn | 1530-0293 | - |
dc.identifier.uri | https://scholarworks.bwise.kr/cau/handle/2019.sw.cau/8947 | - |
dc.description.abstract | Objectives: Many comatose patients following cardiac arrest have ischemic brain injury. Diffusion-weighted imaging is a sensitive tool to identify hypoxic-ischemic brain injury. The accurate prediction of the prognosis for comatose cardiac arrest survivors has been challenging, and thus, a multimodal approach, combining diffusion-weighted image findings, could be feasible. The aim of this study was to assess regional brain injury on diffusion-weighted imaging and to test the potential association with its neurologic outcome in patients treated with target temperature management after out-of-hospital cardiac arrest. Design and Setting: A multicenter, registry-based, retrospective cohort study was conducted using cases from 24 hospitals across South Korea. Of the 930 adult ( 18 yr) nontraumatic out-of-hospital cardiac arrest patients treated with target temperature management between January 2007 and December 2012 at these hospitals, we included the patients who underwent brain diffusion-weighted imaging in the first week after cardiac arrest. The brain regions examined included the four cerebral lobes, basal ganglia-thalamus, brain stem, and cerebellum. Imaging results were compared between a good neurologic outcome, defined as a cerebral performance category score of 1 or 2, and a poor neurologic outcome (cerebral performance category score 3). Measurement and Main Results: Poor neurologic outcome occurred in 118 of the 172 patients analyzed (68.6%). Positive diffusion-weighted image findings, defined as any regional brain injury lesion in diffusion-weighted imaging, were present in 106 patients. Positive diffusion-weighted image findings had 93% sensitivity, 86% specificity, 76% positive predictive value, and 96% negative predictive value for a poor neurologic outcome. The poor outcome group had higher numbers of affected brain lesions than the good outcome group (3.8 1.9 vs 0.1 +/- 0.6; p < 0.01). By multivariate analysis, positive diffusion-weighted image findings (odds ratio, 58.2; 95% CI, 13.29-254.91) and lack of a shockable rhythm (odds ratio, 0.13; 95% CI, 0.03-0.57) were associated with a poor neurologic outcome. Conclusions: Diffusion-weighted imaging allows reliable prediction of poor neurologic outcome in comatose patients treated with target temperature management after out-of-hospital cardiac arrest. Further prospective validation study will be required to generalize this result. | - |
dc.format.extent | 8 | - |
dc.language | 영어 | - |
dc.language.iso | ENG | - |
dc.publisher | LIPPINCOTT WILLIAMS & WILKINS | - |
dc.title | Predicting Outcome With Diffusion-Weighted Imaging in Cardiac Arrest Patients Receiving Hypothermia Therapy: Multicenter Retrospective Cohort Study | - |
dc.type | Article | - |
dc.identifier.doi | 10.1097/CCM.0000000000001263 | - |
dc.identifier.bibliographicCitation | CRITICAL CARE MEDICINE, v.43, no.11, pp 2370 - 2377 | - |
dc.description.isOpenAccess | N | - |
dc.identifier.wosid | 000362826200013 | - |
dc.identifier.scopusid | 2-s2.0-84944447774 | - |
dc.citation.endPage | 2377 | - |
dc.citation.number | 11 | - |
dc.citation.startPage | 2370 | - |
dc.citation.title | CRITICAL CARE MEDICINE | - |
dc.citation.volume | 43 | - |
dc.type.docType | Article | - |
dc.publisher.location | 미국 | - |
dc.subject.keywordAuthor | cardiac arrest | - |
dc.subject.keywordAuthor | hypothermia | - |
dc.subject.keywordAuthor | magnetic resonance imaging | - |
dc.subject.keywordAuthor | outcome | - |
dc.subject.keywordPlus | CARDIOPULMONARY-RESUSCITATION | - |
dc.subject.keywordPlus | COMATOSE SURVIVORS | - |
dc.subject.keywordPlus | PROGNOSTIC VALUE | - |
dc.subject.keywordPlus | MRI | - |
dc.subject.keywordPlus | CARE | - |
dc.subject.keywordPlus | ADMISSION | - |
dc.subject.keywordPlus | SYSTEM | - |
dc.relation.journalResearchArea | General & Internal Medicine | - |
dc.relation.journalWebOfScienceCategory | Critical Care Medicine | - |
dc.description.journalRegisteredClass | sci | - |
dc.description.journalRegisteredClass | scie | - |
dc.description.journalRegisteredClass | scopus | - |
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