Prognosis value of gray-white-matter ratios in comatose survivors after in-hospital cardiac arrest

Background: The gray-white-matter ratio (GWR) measured on cerebral non-contrasted computed tomography (NCCT) has been reported to help the prognostication of mortality or comatose status of out-of-hospital cardiac arrest (OHCA) victims. Since the etiologies and resuscitative process differ signifi cantly between patients with OHCA and in-hospital cardiac arrest (IHCA), the predictive ability of GWR in IHCA survivors remains unclear. Methods: This retrospective observational study conducted in a single tertiary medical center in Taiwan enrolled all the non-traumatic IHCA adults with sustained return of spontaneous circulation (ROSC) and had received cerebral NCCT examination within 24 hours following cardiac arrest. The GWR of survivor and non-survivor as well as good and poor neurological outcome were analyzed. Results: A total of 79 IHCA patients with 68.4% in male gender and mean age of 66-year-old were enrolled in the current study. Thirty-four patients (43.0%) survived to hospital discharge and 20 patients (25.3%) were discharged with good neurological outcome. The median GWR of patients with good and poor outcomes in either aspect of survival or neurological function did not show signifi cant difference. The area under the plotted receiver of characteristic curves of each GWR did not also show satisfactory predictive performance. Conclusion: The use of GWR for outcome prognosis of patients in emergency department who progressed to circulatory failure did not show promising result. ? 2020 Ainosco Press. All rights reserved.