When a Slice Is Not Enough! Comparison of Whole-Brain versus Standard Limited-Slice Perfusion Computed Tomography in Patients with Severe Traumatic Brain Injury
Abstract
:1. Introduction
2. Patients and Methods
3. Results
4. Discussion
5. Conclusions
Author Contributions
Conflicts of Interest
References
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Number of Patients | 49 | |
---|---|---|
Age (years): median (IQR) | 35 (19.5–50.5) | |
Male: n (%) | 42 (86%) | |
Blunt trauma: n (%) | 49 (100%) | |
Clinical variables | ||
Pre-intubation GCS: median (IQR) | 5 (3–6) | |
ISS: mean (SD) | 30 (9.7) | |
HNAIS: median (IQR) | 4 (3–5) | |
Lactate on arrival: median (IQR) | 2.8 (0.7–4.9) | |
Base deficit on arrival: median (IQR) | 2.4 (1.6–6.4) | |
Rotterdam NCCT score: median (IQR) | 2 (2–2) | |
Outcome variables | ||
ICU length of stay (days): median (IQR) | 10 (6–15) | |
Mortality: n (%) | 8 (16%) | |
Unfavourable GOSE at 6 months: n (%) | 39 (59%) |
PCT Result | LBPCT | WBPCT | p-Value |
---|---|---|---|
Perfusion abnormality: n (%) | 37 (76) | 39 (80) | 0.8 |
Perfusion abnormalities detected: n | 68 | 90 | |
Perfusion abnormalities detected per patient: median (IQR) | 1 (1–2) | 2 (1–3) | <0.001 |
New Finding by WBPCT | n (%) |
---|---|
Additional perfusion abnormality | 15 (38%) |
Increased axial size | 12 (31%) |
Increased longitudinal size | 36 (92%) |
Any additional information on WBPCT | 38 (97%) |
New abnormality or increased axial size | 23 (59%) |
New Abnormality | No New Abnormality | p | ||
---|---|---|---|---|
Number of patients | 15 | 34 | ||
Age (years): median (IQR) | 35 (22.5–60.0) | 34 (23.0–53.0) | 0.672 a | |
Male: n (%) | 13 (87%) | 29 (85%) | 1.000 b | |
Pre-intubation GCS: median (IQR) | 5 (3.5–7.0) | 4 (3.0–6.0) | 0.679 b | |
ISS: mean (SD) | 24.6 (9.2) | 13.1 (8.8) | 0.727 c | |
HNAIS: median (IQR) | 4 (2–5) | 4 (3–5) | 0.458 a | |
Lactate on arrival: median (IQR) | 3.0 (2.3–4.0) | 2.6 (1.7–4.1) | 0.291 a | |
Base deficit on arrival: median (IQR) | 1.8 (1.0–3.9) | 2.8 (1.3–5.4) | 0.515 a | |
Rotterdam NCCT score: median (IQR) | 2 (2.0–2.5) | 2 (2.0–2.0) | 0.946 a | |
ICU length of stay (days): median (IQR) | 12 (8–16) | 9 (6–15) | 0.415 a | |
Mortality: n (%) | 2 (13%) | 6 (18%) | 0.328 b | |
Favourable GOSE at 6 months: n (%) | 6 (40%) | 14 (41%) | 0.597 b |
Increased Axial Dimension on WBPCT | No Increased Axial Dimension on WBPCT | p-Value | ||
---|---|---|---|---|
Number of patients | 12 | 37 | ||
Age (years): median (IQR) | 36 (23.0–50.0) | 35 (23.0–55.0) | 0.963 a | |
Male: n (%) | 10 (83%) | 32 (87%) | 1.000 b | |
Pre-intubation GCS: median (IQR) | 4 (3.0–6.5) | 5 (3.0–6.0) | 0.556 b | |
ISS: mean (SD) | 33.1 (8.4) | 30.0 (8.9) | 0.265 c | |
HNAIS: median (IQR) | 4 (3–5) | 4.5 (2.5–5.5) | 0.864 a | |
Lactate on arrival: median (IQR) | 4.1 (3.3–5.1) | 2.5 (1.9–3.7) | 0.039 a | |
Base deficit on arrival: median (IQR) | 2.3 (0.6–5.4) | 2.4 (1.3–4.3) | 0.780 a | |
Rotterdam NCCT score: median (IQR) | 2 (2.0–3.5) | 2 (1.5–2.0) | 0.212 a | |
ICU length of stay (days): median (IQR) | 13 (9–19) | 9 (6–15) | 0.108 a | |
Mortality: n (%) | 3 (25%) | 5 (13%) | 0.385 b | |
Favourable GOSE at 6 months: n (%) | 2 (17%) | 18 (49%) | 0.089 b |
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Cooper, S.; Bendinelli, C.; Bivard, A.; Parsons, M.; Balogh, Z.J. When a Slice Is Not Enough! Comparison of Whole-Brain versus Standard Limited-Slice Perfusion Computed Tomography in Patients with Severe Traumatic Brain Injury. J. Clin. Med. 2019, 8, 701. https://doi.org/10.3390/jcm8050701
Cooper S, Bendinelli C, Bivard A, Parsons M, Balogh ZJ. When a Slice Is Not Enough! Comparison of Whole-Brain versus Standard Limited-Slice Perfusion Computed Tomography in Patients with Severe Traumatic Brain Injury. Journal of Clinical Medicine. 2019; 8(5):701. https://doi.org/10.3390/jcm8050701
Chicago/Turabian StyleCooper, Shannon, Cino Bendinelli, Andrew Bivard, Mark Parsons, and Zsolt J. Balogh. 2019. "When a Slice Is Not Enough! Comparison of Whole-Brain versus Standard Limited-Slice Perfusion Computed Tomography in Patients with Severe Traumatic Brain Injury" Journal of Clinical Medicine 8, no. 5: 701. https://doi.org/10.3390/jcm8050701