Neuroanesthesia & neurocritical care
Prevalence, semiology and neuroimaging of movements in comatose adults at risk of death by neurologic criteria: a prospective cohort study
Authors' conclusion
SMM and MUO are common among comatose patients at risk of DNC. Their prevalence is similar among alive comatose patients and patients fulfilling clinical criteria for DNC. These movements are not associated with cerebral blood flow on CT-angiography or brain perfusion on CT-perfusion.
Study context
- Population
- Consecutive brain-injured adults with an unconfounded GCS score of 3 at risk of death by neurologic criteria (DNC), 15 ICUs across Canadamedian age 60 [47–69] years
- Participants
- 282 adults
- Outcome
- Prevalence and semiology of spinal-mediated movements (SMM) and movements of unclear neuroanatomic origin (MUO)
Methodological detailsmulticentre, Standardized DNC clinical evaluation, then brain CT-perfusion scan with CT-angiography reconstructions within 2 h
- Multicentre
- Standardized DNC clinical evaluation, then brain CT-perfusion scan with CT-angiography reconstructions within 2 h
Main finding
As reported in the abstract
Prevalence of spinal-mediated movements (SMM)
27%
95% CI 22–32%
Prevalence of MUO
12%
95% CI 9–16%
Observational data: associations, not effects.
Further findings
Association with presence of cerebral blood flow on CT-angiography
| aOR (95% CI) | ||
|---|---|---|
| SMMAdjusted for age and sex | 1.14 (0.63–2.05) | |
| MUOAdjusted for age and sex | 1.36 (0.61–3.01) | |
| 0.20.5125Adjusted odds ratio (log scale) |
Association with brain perfusion on CT-perfusion
| aOR (95% CI) | ||
|---|---|---|
| SMMAdjusted for age and sex | 1.44 (0.77–2.68) | |
| MUOAdjusted for age and sex | 1.75 (0.77–3.97) | |
| 0.20.5125Adjusted odds ratio (log scale) |
Patients fulfilling clinical criteria for DNC (subgroup, n = 204)
- Findings similar in the subgroup
Original publication
Composed by AI from the published abstract and checked against it. How Briefs are made →