ArticleNeurocritical care2023
A Simple Echocardiographic Approach in Assessing the Prognosis of Comatose Patients with Acute Intracerebral Hemorrhage by Using Right Ventricle-Pulmonary Artery Coupling.
Article in Neurocritical care, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundIt remains a challenge to judge whether comatose patients with acute intracerebral hemorrhage (ICH) can wake up. Here, we aimed to investigate the changes in right ventricle-pulmonary artery (RV-PA) coupling over time in these patients and to evaluate its performance for discriminating between those who woke up within 60 days and those who did not.
methodsThirty-five comatose patients with acute spontaneous ICH underwent bedside echocardiography on days 1, 3, and 5 after onset with the measurement of tricuspid annular plane systolic excursion and mean pulmonary artery pressure. The RV-PA coupling (the ratio of tricuspid annular plane systolic excursion to mean pulmonary artery pressure) was calculated.
resultsWithin 60 days of the onset of coma, 11 individuals awakened and survived, and 24 individuals died. In awakened patients, RV-PA couplings did not differ among days 1, 3, and 5 (1.62 ± 0.38 vs. 1.61 ± 0.32 vs. 1.64 ± 0.25 mm/mm Hg, P > 0.05), whereas in unawakened patients, they decreased drastically from day 1 to day 3 and then to day 5 (1.26 ± 0.32 vs. 0.63 ± 0.05 vs. 0.43 ± 0.06 mm/mm Hg, P < 0.05). The area under receiver operating characteristic curve of 0.992 for the ratio of RV-PA coupling on day 5 to day 1 of the coma was superior to that for the Glasgow Coma Scale (area under receiver operating characteristic curve of 0.606) in the discrimination of comatose patients with ICH who woke up within 60 days from those who did not. The optimal cutoff value was 0.536, with a sensitivity of 100.00%, a specificity of 96.24%, and an accuracy of 97.13%.
conclusionsRight ventricle-pulmonary artery coupling demonstrated a high performance for discriminating comatose patients with ICH who woke up within 60 days from those who did not.
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