Prognostic Values of the Gray-to-White Matter Ratio on Brain Computed Tomography Images for Neurological Outcomes After Cardiac Arrest: A Meta-Analysis

Overview

Journal Biomed Res Int

Publisher Wiley

Specialties Biomedical Engineering
Biotechnology
General Medicine

Date 2021 Jan 25

PMID 33490256

Citations 4

Authors

Wen Jie Wang

Jie Cui

Guang Wei Lv

Shun Yi Feng

Yong Zhao

Su Li Zhang

Yong Li

Affiliations

Soon will be listed here.

Abstract

Materials And Methods: The PubMed, ScienceDirect, Web of Science, and China National Knowledge Infrastructure databases were searched for all relevant articles published before March 31, 2020, without any language restrictions. The pooled odds ratios (ORs) and 95% confidence intervals (CIs) were calculated with a random-effects model using Stata 14.0 software.

Result: A total of 24 eligible studies with 2812 CA patients were recruited in the meta-analysis. The pooled result showed that decreased GWR was correlated with poor neurological outcomes after CA (OR = 11.28, 95% CI: 6.29-20.21, and < 0.001) with moderate heterogeneity ( = 71.5%, < 0.001). The pooled sensitivity and specificity were 0.58 (95% CI: 0.47-0.68) and 0.95 (95% CI: 0.87-0.98), respectively. The area under the curve (AUC) of GWR was 0.84 (95% CI: 0.80-0.87). Compared with GWR (cerebrum) and GWR (average), GWR using the basal ganglion level of brain CT had the highest AUC of 0.87 (0.84-0.90). Subgroup analysis indicated that heterogeneity may be derived from the time of CT measurement, preset specificity, targeted temperature management, or proportion of cardiac etiology. Sensitivity analysis indicated that the result was stable, and Deeks' plot showed no possible publication bias ( = 0 .64).

Conclusion: Current research suggests that GWR, especially using the basal ganglion level of brain CT, is a useful parameter for determining neurological outcomes after CA.

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