Cardiothoracic & vascular anesthesia
Brain Computed Tomography Perfusion Facilitates Early Prediction of Neurological Outcomes in Patients Suspected of Ischemic Cerebral Conditions after Cardiac Surgery
Authors' conclusion
In patients with suspected ischemic cerebral events after cardiac surgery, brain CTP, particularly the assessment of the volume of rCBF <30%, demonstrates accuracy in predicting severe neurological disability compared to the initial NCCT scan.
Study context
- Population
- Patients with postoperative neurological symptoms suspected of ischemic stroke after cardiac surgery, university teaching hospital, June 2020 to January 2024
- Participants
- 109 patients
- Exposure
- Brain computed tomography perfusion (CTP) vs non-contrast computed tomography (NCCT) Alberta Stroke Programme Early CT Score (ASPECTS) for predicting severe disability
- Outcome
- Severe disability (mRs score ≥4)
- Follow-up
- At discharge
Methodological detailssingle-centre
- Single-centre
Main finding
As reported in the abstract
Prediction of severe disability (mRs ≥4) at discharge
| Group | AUC |
|---|---|
| ASPECTS-1 | 0.62 (95% CI: 0.52-0.71, p = 0.009) |
| To maximum (Tmax) >6 seconds | 0.67 (95% CI: 0.57-0.76, p < 0.001) |
| Relative cerebral blood flow (rCBF) <30% | 0.73 (95% CI: 0.64-0.81, p < 0.001) |
AUC
ASPECTS-10.62 (95% CI: 0.52-0.71, p = 0.009)
To maximum (Tmax) >6 seconds0.67 (95% CI: 0.57-0.76, p < 0.001)
Relative cerebral blood flow (rCBF) <30%0.73 (95% CI: 0.64-0.81, p < 0.001)
Observational data: associations, not effects.
Further findings
Correlation with Modified Rankin Scale (mRs) at discharge
- Volume of Tmax >6.0 seconds positively correlated with mRs (R2, p)
- R2 = 0.05, p = 0.006
- Volume of rCBF <30% positively correlated with mRs (R2, p)
- R2 = 0.18, p < 0.001
Highest accuracy: rCBF <30% vs follow-up NCCT
- Volume of rCBF <30% highest accuracy
- 0.76, 95% CI: 0.64-0.86, p < 0.001
- Similar accuracy only achieved by follow-up NCCT
- 0.79, 95% CI: 0.67-0.88, p < 0.001
Original publication
Brain Computed Tomography Perfusion Facilitates Early Prediction of Neurological Outcomes in Patients Suspected of Ischemic Cerebral Conditions after Cardiac Surgery. J Cardiothorac Vasc Anesth. Published 3 March 2025. doi:10.
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