Iten, Manuela; Moser, Antonia; Wagner, Franca; Haenggi, Matthias (2024). Performance of the MRI lesion pattern score in predicting neurological outcome after out of hospital cardiac arrest: a retrospective cohort analysis. Critical care, 28(1) BioMed Central 10.1186/s13054-024-05007-w
|
Text
s13054-024-05007-w.pdf - Published Version Available under License Creative Commons: Attribution (CC-BY). Download (1MB) | Preview |
BACKGROUND
Despite advances in resuscitation practice, patient survival following cardiac arrest remains poor. The utilization of MRI in neurological outcome prognostication post-cardiac arrest is growing and various classifications has been proposed; however a consensus has yet to be established. MRI, though valuable, is resource-intensive, time-consuming, costly, and not universally available. This study aims to validate a MRI lesion pattern score in a cohort of out of hospital cardiac arrest patients at a tertiary referral hospital in Switzerland.
METHODS
This cohort study spanned twelve months from February 2021 to January 2022, encompassing all unconscious patients aged ≥ 18 years who experienced out-of-hospital cardiac arrest of any cause and were admitted to the intensive care unit (ICU) at Inselspital, University Hospital Bern, Switzerland. We included patients who underwent the neuroprognostication process, assessing the performance and validation of a MRI scoring system.
RESULTS
Over the twelve-month period, 137 patients were admitted to the ICU, with 52 entering the neuroprognostication process and 47 undergoing MRI analysis. Among the 35 MRIs indicating severe hypoxic brain injury, 33 patients (94%) experienced an unfavourable outcome (UO), while ten (83%) of the twelve patients with no or minimal MRI lesions had a favourable outcome. This yielded a sensitivity of 0.94 and specificity of 0.83 for predicting UO with the proposed MRI scoring system. The positive and negative likelihood ratios were 5.53 and 0.07, respectively, resulting in an accuracy of 91.49%.
CONCLUSION
We demonstrated the effectiveness of the MLP scoring scheme in predicting neurological outcome in patients following cardiac arrest. However, to ensure a comprehensive neuroprognostication, MRI results need to be combined with other assessments. While neuroimaging is a promising objective tool for neuroprognostication, given the absence of sedation-related confounders-compared to electroencephalogram (EEG) and clinical examination-the current lack of a validated scoring system necessitates further studies. Incorporating standardized MRI techniques and grading systems is crucial for advancing the reliability of neuroimaging for neuroprognostication.
TRIAL REGISTRATION
Registry of all Projects in Switzerland (RAPS) 2020-01761.
Item Type: |
Journal Article (Original Article) |
|---|---|
Division/Institute: |
04 Faculty of Medicine > Department of Radiology, Neuroradiology and Nuclear Medicine (DRNN) > Institute of Diagnostic and Interventional Neuroradiology 04 Faculty of Medicine > Department of Intensive Care, Emergency Medicine and Anaesthesiology (DINA) > Clinic of Intensive Care |
UniBE Contributor: |
Iten, Manuela, Wagner, Franca |
Subjects: |
600 Technology > 610 Medicine & health |
ISSN: |
1466-609X |
Publisher: |
BioMed Central |
Language: |
English |
Submitter: |
Pubmed Import |
Date Deposited: |
08 Jul 2024 15:41 |
Last Modified: |
08 Jul 2024 15:49 |
Publisher DOI: |
10.1186/s13054-024-05007-w |
PubMed ID: |
38956665 |
Uncontrolled Keywords: |
Cardiac arrest MR lesion pattern MRI MRI score Neuroprognostication OHCA Out of hospital cardiac arrest |
BORIS DOI: |
10.48350/198448 |
URI: |
https://boris.unibe.ch/id/eprint/198448 |
Actions (login required)
 |
Edit item |