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Elevated cortical blood flow insufficiency volume as a predictor of adverse outcomes in aneurysmal subarachnoid hemorrhage: a large prospective quantitative computed tomography perfusion study.
- Source :
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European Journal of Radiology . Jun2024, Vol. 175, pN.PAG-N.PAG. 1p. - Publication Year :
- 2024
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Abstract
- • This was the largest CTP studies in aSAH, and patients' data were collected prospectively. • Our result demonstrated a novel application scenario for RAPID software. • An elevated preoperative CBFI volume was significantly associated with adverse outcomes in aSAH. • Development and validation of similar parameters might be helpful for future aSAH emergency care. Early hypoperfusion changes exist in patients with aneurysmal subarachnoid hemorrhage (aSAH). We aimed to investigate a readily obtainable quantitative computed tomography perfusion (CTP) parameter that could assist in quickly identifying patients at risk of delayed cerebral ischemia (DCI) and poor 90-day functional outcomes on admission. We prospectively collected data between 2021.04 and 2022.12. Preoperative CTP data were post-processed using RAPID software. The cortical blood flow insufficiency (CBFI) was defined as Time-to-maximum > 4.0 s. Patients were categorized into four groups according to CBFI volume distribution. To minimize differences among the groups, we employed stabilized inverse probability of treatment weighting (sIPTW). The primary outcome was DCI and poor 90-day functional outcomes (modified Rankin Scale, 3–6) was the secondary outcome. Multivariable Cox or Logistic analysis were performed to estimate the association between CBFI volume and the study outcomes, both before and after sIPTW. At baseline, the mean (SD) age of the 493 participants was 55.0 (11.8) years, and 299 (60.6%) were female. One hundred and seven participants with DCI and eighty-six participants with poor 90-day functional outcomes were identified. After sIPTW, CBFI volume demonstrated a significant association with DCI (Cox regression: Group 4 versus Group 1, HR 3.69, 95% CI 1.84–7.01) and poor 90-day functional outcomes (Logistic regression: Group 4 versus Group 1, OR 4.61, 95% CI 2.01–12.50). In this study, an elevated preoperative CBFI volume was associated with adverse outcomes in aSAH patients. More well-designed studies are needed to confirm this association. [ABSTRACT FROM AUTHOR]
Details
- Language :
- English
- ISSN :
- 0720048X
- Volume :
- 175
- Database :
- Academic Search Index
- Journal :
- European Journal of Radiology
- Publication Type :
- Academic Journal
- Accession number :
- 177198371
- Full Text :
- https://doi.org/10.1016/j.ejrad.2024.111456