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Early-Phase Computed Tomography Bowel Diameter and Neurological Outcomes Post-Extracorporeal Cardiopulmonary
Shunki Hiyama1, Mizuki Inoue1, Ken Inoue1
1Tertiary Emergency Medical Center, Tokyo Metropolitan Bokutoh Hospital, 4-23-15 Kotobashi Sumida-ku, Tokyo 130-8575, Japan, metro.tokyo.jp.
Aim:
We aimed to conduct an exploratory investigation on the association between bowel diameter on early-phase abdominal computed tomography (CT) and neurological outcomes in patients undergoing extracorporeal cardiopulmonary resuscitation (ECPR) for out-of-hospital cardiac arrest (OHCA).
Methods:
This observational study included patients who underwent ECPR for OHCA and abdominal CT before intensive care unit admission between January 2015 and December 2021 at a tertiary emergency medical center. Maximum bowel diameter was measured with a picture archiving and communication system by an investigator blinded to outcomes. The primary endpoint was unfavorable neurological outcomes at 1 month, defined as Cerebral Performance Category 3-5. The discriminatory ability of bowel diameter was assessed using the area under the receiver operating characteristic curve (AUC).
Results:
Data from 181 patients were analyzed (median age, 57 years; 84.5% male). Bowel diameter demonstrated a weak ability to predict unfavorable neurological outcomes, with an AUC of 0.58 (95% confidence interval [CI], 0.47-0.70). However, higher discriminatory performance was observed in subgroups of patients aged ≥ 65 years (AUC, 0.83; 95% CI, 0.69-0.96) and those with initial nonshockable rhythms (AUC, 0.69; 95% CI, 0.47-0.91).
Conclusion:
The results of this exploratory investigation suggest that bowel diameter may represent a potential adjunctive marker associated with functional outcomes post-ECPR for OHCA.