Cardiac arrest & resuscitation
Association of ultra-early diffusion-weighted magnetic resonance imaging with neurological outcomes after out-of-hospital cardiac arrest
Authors' conclusion
In this cohort study, PHSI findings on ultra-early DW-MRI were associated with poor neurological outcomes 6 months following the cardiac arrest. The combined CSF NSE levels showed higher sensitivity at 100% specificity than on DW-MRI alone.
Study context
- Population
- Comatose survivors of OHCA, Chungnam national university hospital, Daejeon, Korea, May 2018 to February 2022
- Participants
- 110 survivors
- Exposure
- Presence vs absence of high-signal intensity on ultra-early diffusion-weighted magnetic resonance imaging (DW-MRI)
- PHSIn = 46
- Outcome
- Dichotomised cerebral performance category (CPC): good (CPC 1-2) or poor (CPC 3-5)
- Follow-up
- 6 months
Methodological detailssingle-centre, Median time from ROSC to MRI 2.8 h (IQR 2.0-4.0 h)
- Single-centre
- Median time from ROSC to MRI 2.8 h (IQR 2.0-4.0 h)
Main finding
As reported in the abstract
Good neurological outcome
| Group | Value | AUC for predicting poor outcome | Specificity | Sensitivity |
|---|---|---|---|---|
| PHSI | 0 events | 0.87 (95% CI 0.80-0.93) | 100% (95% CI 91.2%-100%) | 74.2% (95% CI 62.0-83.5%) |
| AHSI | 75% |
Value
PHSI0 events
AHSI75%
AUC for predicting poor outcome
PHSI0.87 (95% CI 0.80-0.93)
AHSI— not stated in the abstract
Specificity
PHSI100% (95% CI 91.2%-100%)
AHSI— not stated in the abstract
Sensitivity
PHSI74.2% (95% CI 62.0-83.5%)
AHSI— not stated in the abstract
- Good neurological outcome overall
- 48 (43.6%)
Observational data: associations, not effects.
Further findings
CSF NSE in AHSI, good vs poor outcome (subgroup)
P < 0.001
PHSI combined with cerebrospinal fluid (CSF) neuron-specific enolase (NSE) for predicting poor outcome
- Sensitivity
- 88.7% [95% CI 77.1-95.1%]
- Specificity
- 100%
Original publication
Association of ultra-early diffusion-weighted magnetic resonance imaging with neurological outcomes after out-of-hospital cardiac arrest. Crit Care. Published 13 January 2023. doi:10.
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