Neurophysiological and neuroradiological test for early poor outcome (Cerebral Performance Categories 3–5) prediction after cardiac arrest: Prospective multicentre prognostication data
Maenia Scarpino,
Francesco Lolli,
Giovanni Lanzo,
Riccardo Carrai,
Maddalena Spalletti,
Franco Valzania,
Maria Lombardi,
Daniela Audenino,
Maria Grazia Celani,
Alfonso Marrelli,
Sara Contardi,
Adriano Peris,
Aldo Amantini,
Claudio Sandroni,
Antonello Grippo
Affiliations
Maenia Scarpino
SODc Neurofisiopatologia, Dipartimento Neuromuscolo-Scheletrico e degli Organi di Senso, AOU Careggi, Florence, Italy; IRCCS, Fondazione Don Carlo Gnocchi, Florence, Italy
Francesco Lolli
Dipartimento di Scienze Biomediche Sperimentali e Cliniche, Università degli Studi di Firenze, Italy
Giovanni Lanzo
SODc Neurofisiopatologia, Dipartimento Neuromuscolo-Scheletrico e degli Organi di Senso, AOU Careggi, Florence, Italy
Riccardo Carrai
SODc Neurofisiopatologia, Dipartimento Neuromuscolo-Scheletrico e degli Organi di Senso, AOU Careggi, Florence, Italy; IRCCS, Fondazione Don Carlo Gnocchi, Florence, Italy
Maddalena Spalletti
SODc Neurofisiopatologia, Dipartimento Neuromuscolo-Scheletrico e degli Organi di Senso, AOU Careggi, Florence, Italy
Franco Valzania
UO Neurofisiopatologia, Arcispedale Santa Maria Nuova, Reggio nell’Emilia, Italy
Maria Lombardi
UO Neurologia, Ospedale San Giuseppe, Empoli, Italy
Daniela Audenino
SC Neurologia, EO Ospedale Galliera, Genova, Italy
Maria Grazia Celani
UO Neurofisiopatologia, Ospedale Santa Maria della Misericordia, Perugia, Italy
Alfonso Marrelli
UOC Neurofisiopatologia, Ospedale San Salvatore, L'Aquila, Italy
Sara Contardi
NeurofisiopatologiaInterventiva, Ospedale civile di Baggiovara, Modena, Italy
Adriano Peris
Unità di Terapia Intensiva, Dipartimento Neuromuscolo-Scheletrico e degli Organi di Senso, AOU Careggi, Florence, Italy
Aldo Amantini
SODc Neurofisiopatologia, Dipartimento Neuromuscolo-Scheletrico e degli Organi di Senso, AOU Careggi, Florence, Italy; IRCCS, Fondazione Don Carlo Gnocchi, Florence, Italy
Claudio Sandroni
Istituto Anestesiologia e Rianimazione Università Cattolica del Sacro Cuore, Fondazione Policlinico Universitario “Agostino Gemelli” IRCCS, Rome, Italy; Corresponding author. Università Cattolica del Sacro Cuore – Fondazione Policlinico Universitario “Agostino Gemelli” –IRCCS, Largo Francesco Vito, 1 – 00168, Rome, Italy.
Antonello Grippo
SODc Neurofisiopatologia, Dipartimento Neuromuscolo-Scheletrico e degli Organi di Senso, AOU Careggi, Florence, Italy; IRCCS, Fondazione Don Carlo Gnocchi, Florence, Italy
The data presented here are related to our research article entitled “Neurophysiology and neuroimaging accurately predict poor neurological outcome within 24 hours after cardiac arrest: a prospective multicentre prognostication study (ProNeCA)” [1].We report a secondary analysis on the ability of somatosensory evoked potentials (SEPs), brain computed tomography (CT) and electroencephalography (EEG) to predict poor neurological outcome at 6 months in 346 patients who were comatose after cardiac arrest. Differently from the related research article, here we included cerebral performance category (CPC) 3 among poor outcomes, so that the outcomes are dichotomised as CPC 1–2 (absent to mild neurological disability: good outcome) vs. CPC 3–5 (severe neurological disability, persistent vegetative state, or death: poor outcome). The accuracy of the index tests was recalculated accordingly. A bilaterally absent/absent-pathological amplitude (AA/AP) N20 SEPs wave, a Grey Matter/White Matter (GM/WM) ratio <1.21 on brain CT and an isoelectric or burst suppression EEG predicted poor outcome with 49.6%, 42.2% and 29.8% sensitivity, respectively, and 100% specificity. The distribution of positive results of the three predictors did not overlap completely in the population of patients with poor outcome, so that when combining them the overall sensitivity raised to 61.2%. Keywords: Cardiac arrest, Anoxia-ischemia, Brain, Coma, Prognosis, Electroencephalogram, Somatosensory evoked potentials, Computed tomography