Neuroanaesthesia & neurocritical care
Optimum timing of cerebral computed tomography angiography for determination of death using neurological criteria: a retrospective sensitivity cohort study
Authors' conclusion
The sensitivity of cerebral CTA increases with the time elapsed after the onset of initial signs of brainstem areflexia. We recommend delaying cerebral CTA until at least 12 h after the onset of initial signs of brainstem areflexia, and, in case of inconclusive results, test repetition at least 12 h later. Further work is required to confirm our findings and increase diagnostic confidence.
Study context
- Population
- Intensive care unit patients undergoing determination of death using neurological criteriaintensive care unit patients assessed retrospectively
- Participants
- 118 patients
- Exposure
- Early vs late
- Outcome
- Cerebral circulatory arrest not confirmed by cerebral CTA; overall sensitivity
Main finding
As reported in the abstract
Cerebral circulatory arrest not confirmed
15 of 118
13%
Overall sensitivity
87.3%
95%CI 79.6–92.5%
Observational data: associations, not effects.
Further findings
Sensitivity
| Outcome | Early | Late | P value |
|---|---|---|---|
| Sensitivity of cerebral CTA, early (≤ 12 h) vs late (> 12 h)Significantly higher sensitivity in the late group · patients secondarily stratified | 67.4% (95% CI 51.3–80.5%) | 98.7% (95% CI 91.8–100%) | P < 0.001 |
False-negative results occurring within 12 h of the onset of initial signs of brainstem areflexia
- Share of false-negative results within 12 h
- 93.3% (95%CI 66.0-99.7%)
Original publication
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