Early Head CT Findings Are Associated With Outcomes After XXXX .

@entity1 @entity1167
OBJECTIVES: Head CT after out-of-hospital @entity1167 is often obtained to evaluate intracranial pathology. Among @entity1 admitted to the PICU following pediatric out-of-hospital @entity1167 , we hypothesized that loss of gray-white matter differentiation and basilar cistern and sulcal effacement are associated with mortality and unfavorable neurologic outcome. DESIGN: Retrospective, cohort study. SETTING: Single, tertiary-care center PICU. @entity1 : Seventy-eight @entity1 less than 18 years old who survived out-of-hospital @entity1167 to PICU admission and had a head CT within 24 hours of return of spontaneous circulation were evaluated from July 2005 through May 2012. INTERVENTIONS: None. MEASUREMENTS AND MAIN RESULTS: Median time to head CT from return of spontaneous circulation was 3.3 hours (1.0, 6.0). Median @entity1 age was 2.3 years (0.4, 9.5). Thirty-nine @entity1 (50%) survived, of whom 29 (74%) had favorable neurologic outcome. Nonsurvivors were more likely than survivors to have 1) loss of gray-white matter differentiation (Hounsfield unit ratios, 0.96 [0.88, 1.07] vs 1.1 [1.07, 1.2]; p < 0.001), 2) basilar cistern effacement (93% vs 7%; p = 0.001; positive predictive value, 94%; negative predictive value, 59%), and 3) sulcal effacement (100% vs 0%; p  <= 0.001; positive predictive value, 100%; negative predictive value, 68%). All @entity1 with poor gray-white matter differentiation or sulcal effacement had unfavorable neurologic outcomes. Only one @entity1 with basilar cistern effacement had favorable outcome. CONCLUSIONS: Loss of gray-white matter differentiation and basilar cistern effacement and sulcal effacement are associated with poor outcome after pediatric out-of-hospital @entity1167 . Select @entity1 may have favorable outcomes despite these findings.
