Radiological signs of hypoxic-ischaemic encephalopathy on head computed tomography for prediction of poor functional outcome after cardiac arrest – a prospective observational cohort study
Authors' conclusion
Extensive and bilateral loss of grey-white matter distinction on CT is associated with poor functional outcome after cardiac arrest and yielded the highest interrater agreement.
Study context
- Population
- Unconscious patients after OHCA in the TTM2 trial with head computed tomography (CT) >48 h ≤7 days post-arrest105 (75%) poor outcome
- Participants
- 140 patients
- Exposure
- Loss of grey-white matter distinction vs Sulcal effacement vs Pseudo Subarachnoid Haemorrhage Sign vs White Cerebellum Sign vs Reversal Sign
- Outcome
- Prognostic performance of CT signs for poor functional outcome (modified Rankin Scale 4-6) and interrater agreement
- Follow-up
- Six months
Methodological detailssub-study of the TTM2 trial, prognostic accuracy, interrater agreement, CT at median 84 h (IQR 66-109) post-arrest; median age 68 years (IQR 59-76); 106 (76%) male
- Sub-study of the TTM2 trial
- Prognostic accuracy
- Interrater agreement
- CT at median 84 h (IQR 66-109) post-arrest; median age 68 years (IQR 59-76); 106 (76%) male
Main finding
As reported in the abstract
Prediction of poor functional outcome
| Group | Sensitivity | Specificity |
|---|---|---|
| Loss of grey-white matter distinction | 45-50% | 100% |
| Sulcal effacement | 29-49% | 93-99% |
| Pseudo Subarachnoid Haemorrhage Sign | 8-11% | 99-100% |
| White Cerebellum Sign | 8-11% | 99-100% |
| Reversal Sign | 8-11% | 99-100% |
Sensitivity
Loss of grey-white matter distinction45-50%
Sulcal effacement29-49%
Pseudo Subarachnoid Haemorrhage Sign8-11%
White Cerebellum Sign8-11%
Reversal Sign8-11%
Specificity
Loss of grey-white matter distinction100%
Sulcal effacement93-99%
Pseudo Subarachnoid Haemorrhage Sign99-100%
White Cerebellum Sign99-100%
Reversal Sign99-100%
- Highest interrater agreement: loss of grey-white matter distinction at high convexity level ("moderate")
- κ = 0.74
Observational data: associations, not effects.
Original publication
Radiological signs of hypoxic-ischaemic encephalopathy on head computed tomography for prediction of poor functional outcome after cardiac arrest – a prospective observational cohort study. Resuscitation. Published 9 June 2025. doi:10.
Composed by AI from the published abstract and checked against it. How Briefs are made →