Prediction Of Functional Recovery Research Articles

QT dispersion in patients with acute ischemic stroke who underwent thrombolytic treatment: Is it really useful to predict good neuorologic recovery?

In the current study, ΔQT dispersion (ΔQTD) was found to be a new predictor of neurologic change which may be potentially useful in prediction of functional recovery in patients with acute cerebrovascular accident treated with thrombolytic treatment. We believe that ΔQTD might be a new prognostic determiner in patients with acute cerebrovascular accident undergoing thrombolytic treatment. But it is too early to talk about the prognostic significance in patients with acute cerebrovascular accident not undergoing thrombolytic treatment.

Abstract 3336: Fractional and Coronary Flow Reserve in Prediction of Functional Recovery of Myocardium in Patients with Previous Myocardial Infarction

Background: Fractional flow reserve (FFR) may provide clinically useful diagnostic information both in patients (pts) with normal left ventricular (LV) function as well as in pts with previous myocardial infarction (MI). However, the question remains to the relation between improvement of FFR and improvement of LV function in pts with previous MI undergoing percutaneous coronary intervention (PCI). Aim: The aim of the study was to evaluate the relation between FFR and simultaneously evaluated coronary flow reserve by thermodilution (CFRthermo), with functional improvement of LV function in pts with previous MI undergoing PCI. Methods: Study population consisted of 50 pts (mean age 53±8 years; 40 male) with previous MI and significant coronary stenosis in one-vessel CAD (33 LAD, 4 Cx, 13 RCA) undergoing PCI of infarct-related coronary artery. In all pts we have evaluated by single pressure/thermo wire FFR and CFRthermo before and immediately after PCI. In all pts, we have evaluated LV ejection fraction by echo and wall motion score index (WMSI) before and 3 months after PCI. Results: Coronary lesions were successfully treated in all pts with decrease of diameter stenosis from 63±7% to 18±9% (p<0.001). FFR increased significantly (p<0.001) from 0.62±0.15 to 0.91±0.06 after PCI, whereas CFRthermo increased significantly (p<0.01) from 1.5±0.3 to 2.5±0.7. LV ejection fraction increased from 49±6% to 55±8% (p<0.0001), and WMSI decreased from 1.44±0.24 to 1.29±0.29 (p<0.0001). LV functional improvement was observed in 33/50 (66%) of pts. In pts with LV functional recovery in comparison to pts with no recovery there was significant difference in FFR before PCI (0.57±0.15 vs. 0.71±0.11, p=0.001), improvement of FFR during PCI (0.34±0.15 vs. 0.21±0.13, p=0.004), improvement of CFRthermo during PCI (1.2±0.6 vs. 0.6±0.5, p=0.001) and CFRthermo after PCI (2.7±0.7 vs. 2.1±0.6, p=0.008), respectively. Conclusion: Evaluation of FFR and CFRthermo provide significant prognostic information on LV functional recovery in pts with previous MI undergoing PCI. Lower FFR before PCI, higher CFRthermo after PCI, as well as higher improvement of FFR and CFRthermo during PCI are indicative of left ventricular functional improvement in pts with previous MI.

Abstract 2701: Late Gadolinium Enhancement Cardiovascular Magnetic Resonance Predicts Lack of Functional Recovery in Patients with New Onset Heart Failure Undergoing Optimal Therapy

Background : Some patients with heart failure may have a marked improvement in left ventricular function (LVF) even in the absence of optimized drug therapy. Previous data shows that the proportion of patients matching the criteria for device implantation dropped significantly after 6 months on optimal medial therapy. However the predictors of recovery in LVF are not well understood. Objetive : We evaluated the feasibility of using late gadolinium enhancemnet cardiovascular magnetic resonance (LGE-CMR) to predict the improvement in LVF in new onset heart failure (AHF) patients on optimized medical therapy. Methods : Seventy six patients admitted with AHF and EF < 35% underwent LGE-CMR. Baseline and follow-up echocardiography was performed to assess functional recovery. We evaluated change in the proportion of patients who satisfied criteria for device implantation (EF< 35%) after 7 month on optimal therapy. Results : During follow-up 81% were treated with B-Blockers, 91% with ACEI and 33% with spironolactone. Twenty two patients (29%) had late gadolinium enhancement. Change in LVF was significantly hgher in patients who did not show LGE-CMR (p< 0.006). Al follo-up 55% of patients not satisfied criteria for device implantation as they developed functional recovery. Multvariate analysis showed that LGE-CMR (OR 0.10, CI 0.02–0.48, p =0.004), left bundle branch block (OR 0.14 CI 0.03–0.70, p=0.0017) and betablockers (OR 5.94 CI 1.12–31.40, p=0.006) were indepent predictors of functional recovery. Conclusions : The proportion of patients with AHF who satisfied criteria for device implantation as a primary prevention, dropped signifcantly after 7 months on optimal medial treatment. Late gadolinium enhancement CMR is a useful tool to identify these patients

Predictors of Rehabilitation Outcomes: A Comparison of Israeli and Italian Geriatric Post-Acute Care (PAC) Facilities Using the Minimum Data Set (MDS)

To understand the relative contribution of sociodemographic, clinical, and health care features to rehabilitation outcomes in Israel and in Italy in post-acute care (PAC) facilities. Prospective cross-national study Two hospital geriatric PAC departments: Harzfeld Geriatric Hospital, Gedera, Israel, and Catholic University of Sacred Heart Geriatric Hospital, Rome, Italy. Post-acute care patients aged 65 and older admitted consecutively for stabilization, improvement, or rehabilitation to 3 departments in Harzfeld Geriatric Hospital, Gedera, Israel from April, 1999 through February, 2002 (N = 364), and to the post-acute Geriatric Rehabilitation Unit of the "A. Gemelli" Hospital, Catholic University of Sacred Heart, Rome, Italy, between February, 1999, and April, 2002 (N = 351), for whom there were complete assessments at admission and discharge (the total number admitted in Israel was 505, and in Italy, 409). Minimum Data Set for Post-Acute Care (MDS-PAC) assessments conducted within 4 days of admission and at discharge; data collected identically in both sites. Predictors of functional recovery> were identified using multivariate binary logistic regression. The dependent variable: improvement of 1 or more points in the ADL scale. The staffing pattern of the PAC department in Italy had about double the physicians and physio- and occupational therapists than in Israel, but about the same number of nurses and somewhat fewer aides than in Israel. Multivariate binary logistic regression that includes country, age, sex, and marital status, found that the patients in Italy had about triple the probability of improvement in ADL function (OR 3.3, CI 2.4-4.6) (P < .001) than PAC patients in Israel. Even after health system characteristics were added to the model, ADL improvement was most significantly associated with higher cognitive ability and a diagnosis of hip fracture, as well as longer length of stay and being admitted to PAC directly from an acute hospital. For each additional point (worse cognition) in a cognitive scale, there was a 30% decrease in the probability of ADL improvement (OR 0.7, CI 0.6-0.8, P < .001). Those who had a stroke were about half as likely to show ADL improvement (OR 0.5, CI 0.3-0.7) than those without stroke, but those with a hip fracture had more than double the probability of ADL improvement (OR 2.7, CI 1.7-4.2) than those without hip fracture. Those who stayed in the PAC ward an additional block of time had a 30% higher probability of ADL improvement (P < .1), and those who were admitted directly to PAC from an acute hospital had more than 4 times the probability of ADL improvement (OR 4.1, CI 2.3-7.0, P < .001) than those who were admitted from a private home. We found support for the hypothesis that differences in sociodemographic and clinical factors cannot account for all differences in ADL improvement, and that the organization of care and constraints of the health system also influence functional outcomes. Policymakers should examine the policy-amenable features of the Italian and Israeli systems so that optimal ADL recovery can be encouraged. Any reduction in disability will help both patients and the health care system; slightly higher short-term PAC treatment costs may have large long-term future benefits, if they result in the reduction of ADL disability. This study is one of the first to examine outcomes of PAC in 2 countries, and can provide an initial assessment of how rehabilitation can be enhanced or limited by health policies and staffing patterns.

Acute Physiologic Predictors of Mortality and Functional and Cognitive Recovery in Hemorrhagic Stroke: 1-, 3-, and 6-month Assessments

This study was conducted to evaluate the prognostic values of acute physiologic parameters of mortality and functional and cognitive recovery. We studied 108 patients with hemorrhagic stroke admitted within 24 hours after stroke onset to a neurologic intensive care department. Details concerning potential physiologic predictors were collected (i.e., systolic and diastolic blood pressure, pulse rate, respiration rate, body temperature, hematocrit, Pao(2), Paco(2) and serum osmolality, pH, cholesterol, and glucose levels) at admission. As outcome variables, mortality and functional and cognitive recovery at 1, 3, and 6 months were measured. Results showed that blood pressure, serum pH, and Pao(2) on admission are significant predictors of mortality; that respiratory rate and hematocrit on admission are significant predictors of functional recovery; and that respiratory rate, Pao(2), and heart rate on admission predict cognitive recovery. It appears that the physiologic predictors of hemorrhagic stroke are remarkably dependent on outcome definitions (i.e., mortality, functional disability, or cognitive ability), but not with recovery times.

Impact of stroke etiology, lesion location and aging on post-stroke urinary incontinence as a predictor of functional recovery

This retrospective study aims to assess the relationship of age, gender, lesion location, stroke etiology and recurrence of stroke to post-stroke urinary incontinence, and to evaluate its impact on functional recovery in patient subgroups with different etiologies, lesion locations and ages. One-hundred-and-sixty-three stroke patients participated in the study. Among them, 141 had detailed imaging tests for the definition of lesion locations. Post-stroke urinary incontinence was defined as an inability to respond to questions regarding toilet needs, evidence of elevated post-stroke urinary incontinence and retention. Successful rehabilitation was described as a total functional independence measure score over 80 at discharge. Cerebrovascular lesion locations were categorized as cortical, subcortical and disseminated. The study found that post-stroke urinary incontinence had a significant negative impact on successful stroke rehabilitation. Post-stroke urinary incontinence was a better indicator of negative functional outcome in hemorrhagic versus ischemic stroke patients and patients with cortical versus subcortical lesions. The incidence of post-stroke urinary incontinence in patients aged over 75 years was higher than in patients under 75 years (P=0.031). In conclusion, post-stroke urinary incontinence was a strong negative predictor of poor outcome in all stroke subgroups. It was related to age, but not to any other pre-selected factor investigated in this study.

Subcortical vascular lesions and functional recovery in older patients with gait disorders

This study aimed to assess whether subcortical vascular lesions (SVLs) predict functional recovery after rehabilitation in elderly patients with gait disorders (GD) due to multiple etiology (GD-ME). All patients consecutively admitted with GD-ME ( n = 103) in our Rehabilitation and Aged Care Unit (RACU) underwent a standardized rehabilitative program. The outcome measure was the Barthel Index (BI) Relative Functional Gain (RFG), a measure of improvement adjusting for baseline functional level. Potential predictors included cognition, depression, functional and nutritional status, physical health, occurrence of adverse clinical events during hospital stay, and SVLs, assessed with a validated visual rating scale based on brain CT scans. Predictors were divided into quartiles and the association with RFG was assessed. In a multivariate linear regression model, SVLs maintained its predictive power on RFG after adjustment for age, gender, and adverse clinical events, which was the only variable associated to RFG in the bivariate model (adjusted p = 0.002 for trend). The study shows that SVLs is a predictor of functional recovery in elderly patients with GD-ME.

Comparative assessment of18F-fluorodeoxyglucose PET and99mTc-tetrofosmin SPECT for the prediction of functional recovery in patients with reperfused acute myocardial infarction

Although preserved glucose metabolism is considered to be a marker of myocardial viability in the chronic stage, it has not been fully elucidated whether this is also true with regard to reperfused acute myocardial infarction (AMI). The aim of this study was to compare the diagnostic performance of(99m)Tc-tetrofosmin SPECT and(18)F-fluorodeoxyglucose (FDG) PET for the prediction of functional recovery in reperfused AMI. The study population comprised 28 patients. Both tetrofosmin SPECT and FDG PET were performed in all 28 patients at ca. 2 weeks and in 23 at 6 months. The tetrofosmin and FDG findings in infarct-related segments were compared with the regional wall motion score assessed by left ventriculography over 6 months to determine the predictive value for functional recovery. Of 120 infarct-related segments, 83 had preserved flow (tetrofosmin uptake >/=50%) and 81 had preserved glucose metabolism (FDG uptake >/=40%). The sensitivity and specificity of tetrofosmin SPECT for the prediction of functional recovery tended to be superior to those of FDG PET (90.0% and 72.5% vs 85.0% and 67.5%, respectively). Thirteen segments with preserved flow and decreased glucose metabolism demonstrated marked recovery of contractile function from 2.5+/-1.0 to 1.4+/-1.4 (p<0.01), with restoration of glucose metabolism at 6 months. In contrast, 11 segments with decreased flow and preserved glucose metabolism demonstrated incomplete functional improvement from 3.0+/-0.8 to 2.2+/-1.2. In the subacute phase, preserved myocardial blood flow is more reliable than glucose metabolism in predicting functional recovery in reperfused myocardium.

Value of Coronary Blood Flow Pattern as a Predictor of Functional Recovery and Short-Term Left Ventricular Remodeling After Primary Coronary Angioplasty. A Transthoracic Doppler Study

Coronary blood flow measurement using a Doppler guidewire is the most sensitive way of detecting the no-reflow phenomenon following reperfusion of a myocardial infarction (MI). New high-frequency Doppler probes enable coronary blood flow velocity to be measured noninvasively. Our aims were to study the different patterns of left anterior coronary artery blood flow observed by transthoracic Doppler echocardiography, and to describe their association with functional recovery following reperfusion of an anterior MI. The study included 57 patients with a mean age of 60 years (range 30-85 years). An abnormal coronary blo:d flow pattern was defined as one in which there was a high peak diastolic velocity and a short deceleration time (i.e., < or = 500 ms). We compared the regional contractility, ventricular volumes, and left ventricular ejection fraction (LVEF) measured after 72 hours with those measured 1 month after MI. Overall, 31 patients (54%) had a normal coronary blood flow pattern (Group 1) and 26 (46%), an abnormal pattern (Group 2). After one month, regional contractility improved in Group-1 patients, as did LVEF, from 46.8 (8.6) to 52.6 (8.8)% (P=.002). In these patients, left ventricular volumes were unchanged. In contrast, regional contractility and LVEF remained unchanged in Group-2 patients whereas ventricular volumes increased, from 55.8 (12.9) to 62.9 (16.8) ml/m2 (P=.05), and from 32.2 (9.5) to 37.1 (14.9) ml/m2 (P< .05). Coronary blood flow pattern was the most important independent predictor of left ventricular remodeling, odds ratio =6.14 (95% CI, 1.56-24.17). Transthoracic Doppler echocardiographic assessment of coronary blood flow following reperfusion of an anterior myocardial infarction can be used to identify patients with microvascular damage who are progressing towards ventricular dilatation without recovery of myocardial function.

Prediction of functional recovery after revascularization in patients with chronic ischaemic left ventricular dysfunction: head-to-head comparison between 99mTc-sestamibi/18F-FDG DISA SPECT and 13N-ammonia/18F-FDG PET

(18)F-FDG PET is an important modality for myocardial viability assessment in patients with left ventricular (LV) dysfunction. Dual-isotope simultaneous acquisition (DISA) SPECT may be an alternative to PET. The aim of this study was to compare the diagnostic performance of PET and DISA SPECT for the prediction of improvement in regional and global LV function as well as LV reverse remodelling after revascularization. Patients (n=47) with chronic coronary artery disease and LV dysfunction underwent DISA SPECT (with (99m)Tc-sestamibi and (18)F-FDG) and PET (with (13)N-ammonia and (18)F-FDG) on the same day to assess viability. All patients underwent revascularization and recovery of function was derived from serial magnetic resonance imaging studies. Of 264 revascularized, dysfunctional segments, 143 (54%) improved in function. For prediction of improvement in regional LV function, PET and DISA SPECT had similar sensitivity (90% versus 89%, NS) and specificity (86% versus 86%, NS). For prediction of improvement in global LV function, sensitivity was 83% for DISA SPECT and 86% for PET (p=NS), whereas both modalities had a specificity of 100%. Finally, sensitivity and specificity for the prediction of LV reverse remodelling were also similar for DISA SPECT and PET. In patients undergoing revascularization, DISA SPECT and PET predict the improvement in regional and global LV function and LV remodelling equally well post revascularization.

Prediction of functional recovery after revascularization in patients with coronary artery disease and left ventricular dysfunction by gated FDG-PET

Prediction of functional recovery after revascularization in patients with coronary artery disease and left ventricular dysfunction by gated FDG-PET

Prediction of functional recovery after revascularization in patients with coronary artery disease and left ventricular dysfunction by gated FDG-PET

Traditionally, cardiac fluorodeoxyglucose (FDG) uptake is combined with regional perfusion for optimal evaluation of viability. Gated FDG-positron emission tomography (PET) may be an alternative technique for detection of viability because it permits combined assessment of glucose metabolism uptake and wall thickening (WT). In this study the value of FDG uptake and WT (analyzed from a stand-alone gated FDG-PET study) for the prediction of recovery of regional and global left ventricular (LV) function in patients with coronary artery disease undergoing revascularization is studied. Thirty-eight patients with chronic coronary artery disease and LV dysfunction were included. Patients underwent gated FDG-PET to assess viability. Magnetic resonance imaging was performed before and 6 months after revascularization to assess regional and global LV function and LV volumes. Of the 213 revascularized dysfunctional segments, 133 (62%) exhibited functional recovery on follow-up magnetic resonance imaging. Receiver operating characteristic curve analysis indicated that a cutoff level for FDG uptake of 50% or greater yielded a sensitivity and specificity of 93% and 85%, respectively, on gated FDG-PET for prediction of improvement in regional function. Similarly, a cutoff level of 10% or greater for WT was optimal with a sensitivity and specificity of 89% and 78%, respectively. Improvement in LV ejection fraction was best predicted by the number of viable segments. Reverse LV remodeling could be predicted with a sensitivity and specificity of 89% and 65%, respectively, by use of FDG uptake of 50% or greater and 78% and 70%, respectively, by use of WT of 10% or greater. Accurate prediction of outcome after revascularization (including improvement in regional and global LV function and reverse remodeling) is possible with gated FDG-PET by use of a threshold of 50% or greater for FDG uptake or a threshold of 10% or greater for WT.

The New Injury Severity Score: Better Prediction of Functional Recovery after Musculoskeletal Injury

Objectives Injury Severity Score (ISS) is the most widely used method of assessing severity of injury in blunt trauma. It has been recognized that, by only allowing the score to consider the worst injury for each body system, ISS underestimates the problems of multiple musculoskeletal injuries. The New ISS (NISS) allows the three most severe injuries to be scored, irrespective of region affected, and may give better prediction of functional recovery in these patients. Methods A prospective cohort study of 200 patients with musculoskeletal injuries, examining the predictive value of ISS and NISS on functional recovery as measured by patient-derived outcome measures (Short Form-36, Sickness Impact Profile, and Musculoskeletal Function Assessment). Results NISS was greater than ISS in 34 patients (17%). NISS showed closer correlation with total scores and subscores of the outcomes measures than did ISS (Spearman's rho ranked test, P < 0.05). Conclusions NISS, a simple modification from ISS, better predicts functional outcomes in survivors of musculoskeletal trauma, and offers an improvement in the assessment of effectiveness of trauma care delivery.

Intrinsic Factors Influencing Post Stroke Brain Reorganization

Reorganization of the brain, specifically the motor cortex surrounding the stroke, accounts for much of the observed neurological recovery following stroke. Not surprisingly, size of the stroke lesion has the greatest impact on neurological recovery in both animal and clinical research studies. Spontaneous recovery of lost function is possible after a cortical lesion, particularly if the lesion is small. Age correlates negatively with recovery; older individuals generally demonstrate slower and less complete recovery. However, age by itself is a poor predictor of functional recovery.

FDG PET semiquantitative analysis in patients with severe ischemic left ventricular dysfunction: Prediction of functional recovery after coronary revascularization

FDG PET semiquantitative analysis in patients with severe ischemic left ventricular dysfunction: Prediction of functional recovery after coronary revascularization

Prediction of functional recovery of 60-min warm ischemic hearts from asphyxiated canine non-heart-beating donors

Prediction of functional recovery of 60-min warm ischemic hearts from asphyxiated canine non-heart-beating donors

Echocardiography for risk stratification of myocardial infarction in the reperfusion era

The prediction of functional recovery or ventricular remodeling plays a central role in the prognostic assessment of acute myocardial infarction (MI) in the reperfusion era. This article reviews the advances of echocardiographic techniques, focusing on the role of low-dose dobutamine stress echocardiography, contrast echocardiography, transthoracic Doppler of the left anterior descending coronary artery, and transmitral Doppler in detecting myocardial viability and predicting outcome after an acute MI. Moreover, the definition of risk for further ischemic events is another major objective in conservatively managed patients post infarction. As such, the prognostic and economic implication of stress echocardiography compared with that of traditional exercise electrocardiography was considered.

Functional independence after major abdominal surgery in the elderly

Elders undergo approximately 40% of more than 1 million major abdominal operations annually. Yet evidence about recovery to preoperative levels of functional independence is limited. This study details course and predictors of functional recovery after elective major abdominal operations in the elderly. This was a prospective cohort of 372 consecutive patients, 60 years old or more, enrolled from surgeons in private practice and two university-affiliated hospitals, assessed preoperatively and postoperatively at 1, 3, and 6 weeks, 3 and 6 months, using self-report and performance-based measures (Activities of Daily Living [ADL], Instrumental Activities of Daily Living [IADL], Medical Outcomes Study Short Form-36 Physical Component and Mental Component Scales [PCS, MCS], Geriatric Depression Scale [GDS], Folstein Mini-Mental State Exam [MMSE], timed walk, functional reach, hand grip strength). Mean age was 69 +/- 6 years with 56% men, 47% nonHispanic Caucasian, and 42% Mexican American; hospital distribution was 49% private, 51% university-affiliated. Maximum functional declines (95% CI) occurred 1 week postoperatively: ADL, 2.8 points (2.4 to 3.2); IADL, 7.6 points (7 to 8.3); SF-36 PCS, 6.5 points (5.4 to 7.6); Mini-Mental State Exam, 0.5 points (0.2 to 0.7); timed walk, 6.8 seconds (5.2 to 8.4); functional reach, 1.7 inches (1.2 to 2.2); grip strength, 2 kilograms (1.3 to 2.7) (p < 0.001 for all). SF-36 mental component scale and Geriatric Depression Scale scores did not worsen. Mean recovery times were: Mini-Mental State Exam, 3 weeks; timed walk, 6 weeks; ADL, SF-36 PCS, and functional reach, 3 months; and IADL, 6 months. Mean grip strength did not return to preoperative status by 6 months. The incidence of persistent disability at 6 months, compared with preoperative status, was: ADL, 9%; IADL, 19%; PCS, 16%; mental component scale, 17%; timed walk, 39%; functional reach, 58%; and grip strength, 52%. Potentially modifiable independent predictors of ADL and IADL recovery were preoperative physical conditioning and depression plus serious postoperative complications. The clinical course of functional recovery varied across different measures. Protracted disability at 6 months after operation was substantial. Several potentially modifiable factors consistently predicted recovery.

P1-049 Cognitive impairment is an independent predictor of functional recovery after hip fracture surgery but not after elective hip arthroplasty

P1-049 Cognitive impairment is an independent predictor of functional recovery after hip fracture surgery but not after elective hip arthroplasty

Myocardial wall thickness predicts recovery of contractile function after primary coronary intervention for acute myocardial infarction

ObjectivesWe sought to determine whether end-diastolic wall thickness (EDWT) can predict recovery of regional left ventricular contractile function after percutaneous coronary intervention (PCI). BackgroundRegional contractile function does not recover in all patients after PCI for acute myocardial infarction (AMI). Prediction of functional recovery after AMI may help in clinical decision making. MethodsForty consecutive patients with AMI were studied with left ventricular contrast echocardiography for accurate wall thickness and function measurement and myocardial perfusion immediately after and two months following PCI. ResultsOut of 640 segments, 175 (27%) dysfunctional segments in the infarct territory were analyzed for EDWT, wall function, and perfusion. One hundred and three (59%) dysfunctional segments presented with an EDWT <11 mm and 72 (41%) presented with an EDWT ≥11 mm. Perfusion (partial or complete) was present in 63 segments with an EDWT <11 mm (61%) and 71 segments with an EDWT ≥11 mm (99%) (p < 0.001). At two months' follow-up, 66 of 72 segments with an EDWT ≥11 mm (92%) improved, whereas only 35 of 103 of the dysfunctional segments with an EDWT <11 mm (34%) improved (p < 0.0001). ConclusionsWall thickness is an easy parameter to predict recovery of function after revascularization. Moreover, combining EDWT and perfusion, segments with an EDWT ≥11 mm, and presence of perfusion have the highest chance of recovery; segments with an EDWT <11 mm and perfusion have an intermediate chance of recovery. In segments with an EDWT <11 mm and no perfusion, chances of recovery are very low.