Computed tomography perfusion assessment of poor neurological outcome in comatose cardiac arrest patients (CANCCAP): a prospective study

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dc.contributor.authorShankar, Jai
dc.contributor.authorAlcock, Susan
dc.contributor.authorWiens, Evan
dc.contributor.authorAyroso, Marco
dc.contributor.authorPark, JaeYeon
dc.contributor.authorSingh, Navjit
dc.contributor.authorBlackwood, Benjamin
dc.contributor.authorTrivedi, Reva
dc.contributor.authorMarin, Roman
dc.contributor.authorSinha, Namita
dc.contributor.authorTrivedi, Anurag
dc.contributor.authorKirkpatrick, Iain
dc.contributor.authorEssig, Marco
dc.contributor.authorSchaffer, Stephen
dc.date.accessioned2025-06-13T20:59:51Z
dc.date.available2025-06-13T20:59:51Z
dc.date.issued2025-05-23
dc.date.updated2025-06-01T03:29:26Z
dc.description.abstractAbstract Background Computed tomography perfusion (CTP) of the brain, are increasingly being employed for the assessment of critically ill patients admitted to intensive care units (ICU), including comatose cardiac arrest patients (CCAP). The purpose of our study was to validate the use of CTP in predicting in-hospital mortality in CCAPs. Method This prospective cohort study enrolled newly admitted adult CCAP, with an out of hospital cardiac arrest (OHCA) and were scheduled for admission to the ICU for further management. Just before ICU admission, CCAP underwent a routine CT scan of the head and CTP of whole head. The treating physicians remained blinded to the CTP results and all patients received standard management. The CTP maps were evaluated to determine a binary outcome of non-survivable brain injury (NSBI), by two independent neuroradiologists, blinded to each other’s assessment and to the clinical history of the patients. Results A total of 91 patients were enrolled and 90 (Male-78; mean age-62 years) were included in the final analysis. One patient declined consent. Of these, 42 individuals (47%) had in-hospital mortality. Patients with in-hospital mortality were older; had higher levels of creatinine, blood urea nitrogen, blood CO2 and lower pH, carbonate, and heart rate. In multivariate analysis, PCI was independently associated with reduction in-hospital mortality. CTP demonstrated exceptionally high specificity (100%; 95% CI 92–100%) and positive predictive value (100%; 95%CI 6.3–100%) for the prediction of NSBI. For CTP, Bennet’s S-score showed excellent agreement between the two readers (s = 0.82–0.95). Conclusion CTP was safe and demonstrated very high specificity and positive predictive value and may be used as an additional diagnostic tool for identifying patients at high risk of in-hospital mortality.
dc.identifier.citationCritical Care. 2025 May 23;29(1):211
dc.identifier.doi10.1186/s13054-025-05454-z
dc.identifier.urihttp://hdl.handle.net/1993/39117
dc.language.isoeng
dc.language.rfc3066en
dc.publisherBMC
dc.rights.holderThe Author(s)
dc.subjectCT perfusion
dc.subjectComatosed cardiac arrest patients
dc.subjectCardiac arrest
dc.subjectIn-hospital mortality
dc.subjectNeurological outcome
dc.titleComputed tomography perfusion assessment of poor neurological outcome in comatose cardiac arrest patients (CANCCAP): a prospective study
dc.typeresearch article
local.author.affiliationRady Faculty of Health Sciences::Max Rady College of Medicine::Department of Radiology
oaire.citation.startPage211
oaire.citation.titleCritical Care
oaire.citation.volume29
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