Related Experiment Video
Updated: Nov 2, 2025
Author Spotlight: A Unique Mouse Model of Asphyxia-Induced Cardiac Arrest
Published on: April 14, 2023
Predictive values of early head computed tomography for survival outcome after cardiac arrest in childhood: a pilot
Kenichi Tetsuhara1,2, Noriyuki Kaku3,4, Yuka Watanabe1
1Department of Pediatrics, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.
Insights
Early head CT scans can predict survival in children after cardiac arrest. Higher mASPECTS scores and specific sGWR values on initial CT scans indicate a better chance of survival and less brain damage in pediatric patients.
Area of Science:
- Pediatric critical care medicine
- Neuroradiology
- Emergency medicine
Background:
- Predicting outcomes for children experiencing cardiac arrest (CA) is complex.
- Early identification of prognostic markers is crucial for guiding treatment and improving survival rates in pediatric CA patients.
Purpose of the Study:
- To identify early prognostic markers for pediatric out-of-hospital cardiac arrest (CA) using head computed tomography (CT) findings.
- To quantitatively assess the degree of brain damage using novel scoring methods.
Main Methods:
- Retrospective analysis of head CT scans from 70 pediatric patients (<16 years) who experienced non-traumatic out-of-hospital CA.
- Quantitative measurement of brain damage using modified Alberta Stroke Program Early CT Score (mASPECTS) and simplified gray-matter-attenuation-to-white-matter-attenuation ratio (sGWR).
Main Results:
- Survivors (n=14) had significantly higher mASPECTS scores compared to non-survivors (n=56) (p=0.035).
- Patients with mASPECTS ≥ 20 all survived.
- An sGWR ≥ 1.14 was associated with a higher survival rate (54.5%) compared to sGWR < 1.14 (13.6%).
- Follow-up MRI confirmed that mASPECTS < 15 correlated with severe brain damage.
Conclusions:
- Early head CT quantitative analysis, particularly mASPECTS and sGWR, can serve as valuable tools for predicting survival in pediatric CA.
- Lower mASPECTS scores are linked to unfavorable neurological outcomes, as assessed by the Pediatric Cerebral Performance Category scale.
Abstract:
Predicting outcomes of children after cardiac arrest (CA) remains challenging. To identify useful prognostic markers for pediatric CA, we retrospectively analyzed the early findings of head computed tomography (CT) of patients. Subjects were non-traumatic, out-of-hospital CA patients < 16 years of age who underwent the first head CT within 24 h in our institute from 2006 to 2018 (n = 70, median age: 4 months, range 0-163). Of the 24 patients with return of spontaneous circulation, 14 survived up to 30 days after CA. The degree of brain damage was quantitatively measured with modified methods of the Alberta Stroke Program Early CT Score (mASPECTS) and simplified gray-matter-attenuation-to-white-matter-attenuation ratio (sGWR). The 14 survivors showed higher mASPECTS values than the 56 non-survivors (p = 0.035). All 3 patients with mASPECTS scores ≥ 20 survived, while an sGWR ≥ 1.14 indicated a higher chance of survival than an sGWR < 1.14 (54.5% vs. 13.6%). Follow-up magnetic resonance imaging for survivors validated the correlation of the mASPECTS < 15 with severe brain damage. Thus, low mASPECTS scores were associated with unfavorable neurological outcomes on the Pediatric Cerebral Performance Category scale. A quantitative analysis of early head CT findings might provide clues for predicting survival of pediatric CA.
More Related Videos
Related Concept Videos
01:28Imaging Studies for Cardiovascular System V: CT
01:21Cardiopulmonary Resuscitation I: Adult
01:25Imaging Studies for Cardiovascular System VI: Calcium -Scoring CT
01:10Computed Tomography
The technique was invented in the 1970s and is based on the principle that as X-rays pass through the body, they are absorbed or reflected at different levels. In the technique, a patient lies on a motorized platform while a computerized axial tomography (CAT) scanner rotates...