The prognostic value of gray-white matter ratio on brain computed tomography in comatose adult survivors from cardiac arrest

Abstract

Objective To evaluate the correlation between the gray-white matter ratio (GWR) and the outcomes of comatose adult survivors from cardiac arrest (CA) in Chinese. Methods Sixty-one CA patients checked with CT scans within 72 hours of resuscitation from January 2011 to January 2016 were included in this single-center retrospective study. Gray and white matter density (Hounsfield units) were measured, and the GWRs were calculated according to previous studies. The prognostic values of the GWRs in predicting poor outcomes (Cerebral Performance Category 3-5) were analyzed. Results The density values of gray matter were significantly higher in the good outcome group than those in the poor one. All GWRs were significantly higher in the good outcome group (P < 0.05). A GWR (basal ganglia) < 1.18 predicted poor outcomes with a sensitivity and specificity of 50.0% and 88.2%, respectively (P = 0.012). Conclusions Low GWRs, determined from brain CT scans in comatose CA patients after resuscitation, were associated with poor neurological outcomes. GWR determination from brain CT can be a useful indicator for outcome prediction aiding in an optimal clinical decision process in comatose survivors from CA. Key words: Cardiac arrest; Coma; Computed tomography; Gray-white matter ratio; Prognosis