Cardiac arrest & resuscitation
Quantitative analysis of early apparent diffusion coefficient values from MRIs for predicting neurological prognosis in survivors of out-of-hospital cardiac arrest: an observational study
Authors' conclusion
In this cohort study, early voxel-based quantitative ADC analysis after ROSC was associated with poor neurological outcomes 6 months after cardiac arrest.
Study context
- Population
- Adult comatose out-of-hospital cardiac arrest (OHCA) survivors with 3-T diffusion-weighted magnetic resonance imaging (DW-MRI) within 6 h of return of spontaneous circulation (ROSC)26% female
- Participants
- 131 survivors
- Exposure
- Early quantitative apparent diffusion coefficient (ADC) values on DW-MRI in poor vs good neurological outcome
- Outcome
- Poor neurological outcome (Cerebral Performance Category 3-5)
- Follow-up
- 6 months after ROSC
Methodological detailsobservational, voxel-based quantitative analysis, prognostic accuracy
- Observational
- Voxel-based quantitative analysis
- Prognostic accuracy
Main finding
As reported in the abstract
Poor neurological outcome; whole brain ADC
- Poor neurological outcome
- 74 (57%)
Observational data: associations, not effects.
Further findings
| Outcome | Mean whole brain ADC | P value |
|---|---|---|
| Prognostic accuracy for poor neurological outcome at FPR 0%PLR + NSE + mean whole brain ADC vs PLR + NSE · more accurate prediction and sensitivity at FPR 0% · multivariable logistic regression | P = 0.03 | |
| AUC | 0.83 | |
| Sensitivity | 51% (95% CI 39.4-63.1) | |
| Cut-off | ≤ 739.2 × 10-6 mm²/s |
- Prognostic accuracy for poor neurological outcome at false positive rate (FPR) 0%: % voxels with ADC below 600 AUC 0.81 · sensitivity 51% (95% CI 39.4-63.1) · cut-off > 17.2%
- Prognostic accuracy for poor neurological outcome at FPR 0%: Pupillary light reflex (PLR) + neuron-specific enolase (NSE) + mean whole brain ADC AUC 0.91 · sensitivity 51%
- Prognostic accuracy for poor neurological outcome at FPR 0%: PLR + NSE AUC 0.86 · sensitivity 30%
Original publication
Quantitative analysis of early apparent diffusion coefficient values from MRIs for predicting neurological prognosis in survivors of out-of-hospital cardiac arrest: an observational study. Crit Care. Published 25 October 2023. doi:10.
Composed by AI from the published abstract and checked against it. How Briefs are made →