Abstract 10475: Heat Loss Augmented by Extracorporeal Circulation is Associated with Overcooling in Cardiac Arrest Survivors Who Underwent Targeted Temperature Management

Circulation ◽  
2021 ◽  
Vol 144 (Suppl_2) ◽  
Author(s):  
Byungkook Lee ◽  
Dong Hun Lee
Keyword(s):  
Water Temperature ◽  
Core Temperature ◽  
Neurological Outcome ◽  
Temperature Management ◽  
Extracorporeal Circuit ◽  
Matched Cohort ◽  
Maintenance Period ◽  
Neurological Outcomes ◽  
The Core ◽  
Poor Neurological Outcome

Introduction: Extracorporeal circuit-based salvage therapy can affect targeted temperature management (TTM) in comatose out-of-hospital cardiac arrest (OHCA) survivors. We investigated the association of patients with extracorporeal device with TTM and neurological outcome. Methods: We performed a retrospective analysis using prospectively collected data from adult comatose OHCA survivors who underwent TTM between October 2015 and December 2020. We defined patients with ECMO and/or CRRT as the extracorporeal group. We calculated the cooling rate during the induction period; the minimum, maximum, and mean time-weighted core temperatures (TWCT), and the standard deviation (SD) of the core temperature and water temperature during the maintenance period based on the temperature measured every minute. We defined the sum of TWCT more and less than 33°C as positive and negative TWCT, respectively. The primary outcome was a poor neurological outcome, defined as cerebral performance category 3-5. We used propensity score (PS) matching to adjust the characteristics of patients who required an extracorporeal circuit device. Results: Of the 223 included patients, 140 (62.8%) patients had poor neurological outcome and 40 (17.9%) patients were categorized into the extracorporeal group. The extracorporeal group had a rapid cooling rate (2.08°C/h [1.13-3.73] vs. 1.24°C/h [0.77-1.79]; p < 0.001). The extracorporeal group had lower mean core temperature; higher core temperature SD; lower positive TWCT; higher negative TWCT; and higher maximum, minimum, and mean water temperature than the no-extracorporeal group. In PS matched cohort, the extracorporeal group had a lower minimum core temperature, lower mean core temperature, higher core temperature SD, higher negative TWCT, higher maximum water temperature, and higher mean water temperature. The neurological outcomes were not different between the two groups, in either the whole or PS-matched cohort. Conclusions: The extracorporeal group achieved the target temperature earlier. The core temperature distribution during the maintenance period was further skewed below 33°C in the extracorporeal group. The extracorporeal group had similar neurological outcomes to the no-extracorporeal group.

Usefulness of the Degree of Blood–brain Barrier Disruption to Predict Neurological Prognosis in Cardiac Arrest Survivors who Wnderwent Target Temperature Management: A Retrospective Study

2020 ◽  
Author(s):  
Ga Ram Jeon ◽  
Hong Joon Ahn ◽  
Jung Soo Park ◽  
Insool Yoo ◽  
Yeonho You ◽  
...  
Keyword(s):  
Cardiac Arrest ◽  
Blood Brain Barrier ◽  
Neurological Outcome ◽  
Scoring System ◽  
Brain Barrier ◽  
Temperature Management ◽  
Target Temperature Management ◽  
Target Temperature ◽  
Neurological Outcomes ◽  
Poor Neurological Outcome

Abstract Background: This study aimed to compare the day-specific association of blood–brain barrier (BBB) disruption with neurological outcomes in out-of-hospital cardiac arrest (OHCA) survivors treated with target temperature management (TTM).Methods: This retrospective single-center study included 68 OHCA survivors, who underwent TTM between April 2018 and December 2019. The albumin quotient (QA) was calculated as [albuminCSF] / [albuminserum] immediately (day 1), and at 24 h (day 2), 48 h (day 3), and 72 h (day 4) after return of spontaneous circulation (ROSC). The degree of BBB disruption was weighted using the following scoring system: 0.07 ≥ QA (normal), 0.01 ≥ QA > 0.007 (mild), 0.02 ≥ QA > 0.01 (moderate), and QA > 0.02 (severe). This system gave it 0 (normal), 1 (mild), 4 (moderate), and 9 (severe) points. Poor neurological outcome was determined at six months after ROSC and was defined as cerebral performance categories 3–5.Results: We enrolled 68 patients (males, 48; 71%); 37 (54%) of them had a poor neurological outcome. The distributions of this outcome at six months in patients with moderate and severe BBB disruption versus the other groups were 19/22 (80%) vs. 18/46 (50%) on day 1, 31/37 (79%) vs. 6/31 (32%) on day 2, 32/37 (81%) vs. 5/31 (30%) on day 3, and 32/39 (85%) vs. 5/29 (30%) on day 4 (P < 0.001). Using ROC analyses, the optimal cutoff values of QA levels for prediction of neurological outcomes were determined as: day 1, > 0.009 (sensitivity 56.8%, specificity 87.1%); day 2, > 0.012 (sensitivity 81.1%, specificity 87.1%); day 3, > 0.013 (sensitivity 83.8%, specificity 87.1%); day 4, > 0.013 (sensitivity 86.5%, specificity 87.1%); sum of all time points, > 0.039 (sensitivity 89.5%, specificity 79.4%); and scoring system, > 9 (sensitivity 91.9%, specificity 87.1%). Conclusions: Our results suggested that QA is a useful tool for predicting neurological outcomes in OHCA survivors treated with TTM. However, the prediction of poor neurological outcome using QA showed low sensitivity at 100% specificity. Thus, it could be used as part of a multimodal approach than as a single prognostic prediction tool.

Effects of Targeted Temperature Management in Patients with Post-Cardiac Arrest Syndrome after an Out-Of-Hospital Cardiac Arrest Caused by Hanging: A Prospective Observational Cohort Study in Japan

2021 ◽  
Author(s):  
Ryuichiro Kakizaki ◽  
Naofumi Bunya ◽  
Shuji Uemura ◽  
Takehiko Kasai ◽  
Keigo Sawamoto ◽  
...  
Keyword(s):  
Logistic Regression ◽  
Cardiac Arrest ◽  
Propensity Score ◽  
Multivariate Logistic Regression Analysis ◽  
Targeted Temperature Management ◽  
Temperature Management ◽  
Matched Cohort ◽  
Neurological Outcomes ◽  
Post Cardiac Arrest Syndrome ◽  
Hospital Cardiac Arrest

Abstract Background: Targeted temperature management (TTM) is recommended for unconscious patients after a cardiac arrest. However, its effectiveness in patients with post-cardiac arrest syndrome (PCAS) by hanging remains unclear. Therefore, this study aimed to investigate the relationship between TTM and favorable neurological outcomes in patients with PCAS by hanging.Methods: This study was a retrospective analysis of the Japanese Association for Acute Medicine out-of-hospital cardiac arrest (OHCA) registry between June 2014 and December 2017 among patients with PCAS admitted to the hospitals after an OHCA caused by hanging. A multivariate logistic regression analysis was performed to estimate the propensity score and to predict whether patients with PCAS by hanging receive TTM. We compared patients with PCAS by hanging who received TTM (TTM group) and those who did not (non-TTM group) using propensity score analysis.Results: A total of 199 patients with PCAS by hanging were enrolled in this study. Among them, 43 were assigned to the TTM group and 156 to the non-TTM group. Logistic regression model adjusted for propensity score revealed that TTM was not associated with favorable neurological outcome at 1-month (adjusted odds ratio [OR]: 1.38, 95% confidence interval [CI]: 0.27–6.96). Moreover, no difference was observed in the propensity score-matched cohort (adjusted OR: 0, 73, 95% CI: 0.10–4.71) and in the inverse probability of treatment weighting-matched cohort (adjusted OR: 0.63, 95% CI: 0.15–2.69).Conclusions: TTM was not associated with increased favorable neurological outcomes at 1-month in patients with PCAS after OHCA by hanging.

scholarly journals 250 Advanced management of out of hospital cardiac arrest: a single-centre experience in a tertiary cardiac intensive care unit

2021 ◽  
Vol 23 (Supplement_G) ◽  
Author(s):  
Laura De Michieli ◽  
Alberto Bettella ◽  
Giulia Famoso ◽  
Luciano Babuin ◽  
Daniele Scarpa ◽  
...  
Keyword(s):  
Cardiac Arrest ◽  
Neurological Outcome ◽  
Univariate Analysis ◽  
Left Ventricular ◽  
Targeted Temperature Management ◽  
Temperature Management ◽  
Left Ventricular Ejection ◽  
Ventricular Ejection Fraction ◽  
Poor Neurological Outcome ◽  
Hospital Cardiac Arrest

Abstract Aims Out-of-hospital cardiac arrest (OHCA) affects around 1/1000 person-years. Following return of spontaneous circulation (ROSC), the patient can manifest neurological impairment. A targeted temperature management (TTM) protocol is recommended to prevent hypoxic–ischaemic brain damage in patients with coma after cardiac arrest. Neuro-prognostication remains substantial for the prediction of clinical outcomes. To study clinical characteristics, overall survival, and neurological outcome of patients with Glasgow Coma Scale (GCS) &lt;8 after ROSC following an OHCA of presumed cardiac cause at our Institution. Secondly, to investigate determinants of a negative neurological outcome. Methods Observational retrospective study evaluating all patients with OHCA of presumed cardiac cause and with GCS &lt; 8 after ROSC treated in an intensive cardiac care unit of a tertiary centre. The study period was from January 2017 to December 2020. Results One-hundred and five patients out of 107 patients initially selected were included in the study (77% male, mean age 67 years). At 30 days, mortality was 41% and 53% of patients had a poor neurological outcome (Cerebral Performance Category, CPC, 3–5). Sixty-nine patients (66%) underwent TTM. In regard of the circumstances of OHCA, index event in a private place [OR = 3.12 (1.43–7.11), P = 0.005], ineffective rhythm changes during resuscitation manoeuvres [OR = 2.40 (1.05–5.47), P = 0.037] and a greater amount of adrenaline administered during resuscitation [OR = 1.62 (1.27–2.06), P &lt; 0.001] were related to a worse neurological outcome. A history of diabetes mellitus [OR = 3.35 (1.26–8.91), P = 0.015], blood lactates at presentation [OR = 1.33 (1.15—1.53), P &lt; 0.001], neuron-specific enolase (NSE) at presentation [OR = 1.055 (1.022–1.089), P &lt; 0.001] and as peak [OR = 1.034 (1.013–1.054), P &lt; 0.001] were associated with a worse neurological outcome. Among the neurological examinations, the presence of status epilepticus on the EEG [OR = 13.97 (1.73–113.02), P = 0.013] was a predictor of a poor neurological outcome. Treatment with targeted temperature management did not show a significant impact in terms of outcome at univariate analysis [OR = 1.226 (0.547–2.748), P = 0.62]. Two models were developed with multivariate logistic regression for the prediction of neurological outcome. The first one, on a statistical basis, considers pupil reactivity after ROSC, NSE as peak and left ventricular ejection fraction (AUC = 92%). The second model, on a clinical basis, considers age, first blood lactate value and NSE as peak (AUC = 89 %). Finally, the performance of the multiparametric MIRACLE score was tested in our population (AUC 0.81 for neurological outcome at 30 days). Conclusions In our population, at 30 days after cardiac arrest, survival rate and the rate of good neurological outcome were comparable to those of the major international registries and studies. Even though patients treated with TTM did not demonstrate significant differences in terms of neurological outcome, this might be related to study-sample size and patient selection. Results in the literature are still controversial on this topic. The MIRACLE score showed a good performance, making it suitable for clinical use in our population. Similarly, the proposed multivariate models are potentially useful for the elaboration of simple and effective prognostic scores in neurological risk stratification.

Abstract 340: Early Invasive Hemodynamics and Outcomes in Cardiac Arrest Survivors Undergoing Targeted Temperature Management

Circulation ◽  
2018 ◽  
Vol 138 (Suppl_2) ◽  
Author(s):  
Aldo L Schenone ◽  
Kevin Chen ◽  
Bashaer Gheyath ◽  
Nyal Borges ◽  
Manshi Li ◽  
...  
Keyword(s):  
Cardiac Arrest ◽  
Hospital Discharge ◽  
Neurological Outcome ◽  
Wide Spectrum ◽  
Temperature Management ◽  
Neurological Outcomes ◽  
Pulmonary Capillary ◽  
Wide Variability ◽  
Favorable Neurological Outcome ◽  
Invasive Hemodynamics

Introduction: Clinical and electrical determinants of survival following cardiac arrest (CA) have been well defined. The prognostic role of early invasive hemodynamics (iHDs) remains unknown. Hypothesis: Early iHDs following CA in survivors undergoing TTM predicts survival and neurological outcomes at hospital discharge. Methods: We reviewed prospectively collected data on CA survivors undergoing TTM in a quaternary CICU between Jan 15 and Jun 17. Patients included were required to have RHC derived iHDs at initiation of TTM. Subjects with cooling initiated before admission and temperature of <36°C prior to obtaining iHDs were excluded. Univariate and multivariate regression were conducted to test whether cardiac index (Fick-CI≥2.2 vs <2.2 liters/min per m 2 ), pulmonary capillary wedge pressure (PCWP≥18 vs <18mmHg), systemic vascular resistance (SVR>1200 vs 800-1200 vs <800 dynes·sec·cm -5 ) or Forrester hemodynamic profiles were predictive of survival and favorable neurological outcomes at hospital discharge. Results: We identified 52 subjects and 26 (50%) survived to hospital discharge, with 21 (40%) achieving a favorable neurological outcome. Wide variability in invasive hemodynamic parameters was noted in this cohort. There was no association between Fick-CI (p=0.45 & p=0.10), PCWP (p=0.90 & p=0.60), SVR (0.95 & p=0.17) or Forrester hemodynamic profiles (p=0.40 & p=0.42) and survival or favorable neurological outcome at discharge. Conclusion: CA survivors undergoing TTM present with a wide spectrum of iHDs highlighting the heterogeneity of the post cardiac arrest syndrome. Early iHDs did not predict survival or neurological outcomes at hospital discharge.

scholarly journals Circulating Levels of miR-574-5p Are Associated with Neurological Outcome after Cardiac Arrest in Women: A Target Temperature Management (TTM) Trial Substudy

2019 ◽  
Vol 2019 ◽  
pp. 1-10 ◽  
Author(s):  
Adeline Boileau ◽  
Antonio Salgado Somoza ◽  
Josef Dankiewicz ◽  
Pascal Stammet ◽  
Patrik Gilje ◽  
...  
Keyword(s):  
Cardiac Arrest ◽  
Neurological Outcome ◽  
Cerebral Performance Category ◽  
Temperature Management ◽  
Target Temperature Management ◽  
Target Temperature ◽  
Circulating Micrornas ◽  
Performance Category ◽  
Poor Neurological Outcome ◽  
Circulating Levels

Purpose. Postresuscitation neuroprognostication is guided by neurophysiological tests, biomarker measurement, and clinical examination. Recent investigations suggest that circulating microRNAs (miRNA) may help in outcome prediction after cardiac arrest. We assessed the ability of miR-574-5p to predict neurological outcome after cardiac arrest, in a sex-specific manner. Methods. In this substudy of the Target Temperature Management (TTM) Trial, we enrolled 590 cardiac arrest patients for which blood samples were available. Expression levels of miR-574-5p were measured by quantitative PCR in plasma samples collected 48 h after cardiac arrest. The endpoint of the study was poor neurological outcome at 6 months (cerebral performance category scores 3 to 5). Results. Eighty-one percent of patients were men, and 49% had a poor neurological outcome. Circulating levels of miR-574-5p at 48 h were higher in patients with a poor neurological outcome at 6 months (p<0.001), both in women and in men. Circulating levels of miR-574-5p were univariate predictors of neurological outcome (odds ratio (OR) [95% confidence interval (CI)]: 1.5 [1.26-1.78]). After adjustment with clinical variables and NSE, circulating levels of miR-574-5p predicted neurological outcome in women (OR [95% CI]: 1.9 [1.09-3.45]), but not in men (OR [95% CI]: 1.0 [0.74-1.28]). Conclusion. miR-574-5p is associated with neurological outcome after cardiac arrest in women.

scholarly journals The Usefulness of Quantitative Analysis of Blood-Brain Barrier Disruption Measured Using Contrast-Enhanced Magnetic Resonance Imaging to Predict Neurological Prognosis in Out-of-Hospital Cardiac Arrest Survivors: A Preliminary Study

2020 ◽  
Vol 9 (9) ◽  
pp. 3013
Author(s):  
Ho Il Kim ◽  
In Ho Lee ◽  
Jung Soo Park ◽  
Da Mi Kim ◽  
Yeonho You ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Cardiac Arrest ◽  
Magnetic Resonance ◽  
Neurological Outcome ◽  
Resonance Imaging ◽  
Neurological Outcomes ◽  
Outcome Group ◽  
Contrast Enhanced ◽  
Poor Neurological Outcome ◽  
Hospital Cardiac Arrest

We aimed to evaluate neurological outcomes associated with blood-brain barrier (BBB) disruption using contrast-enhanced magnetic resonance imaging (CE-MRI) in out-of-hospital cardiac arrest (OHCA) survivors. This retrospective observational study involved OHCA survivors who had undergone CE-MRI for prognostication. Qualitative and quantitative analyses were performed using the presence of BBB disruption (pBD) and the BBB disruption score (sBD) in CE-MRI scans, respectively. For the sBD, 1 point was assigned for each area of BBB disruption, and 6 points were assigned when an absence of intracranial blood flow due to severe brain oedema was confirmed. The primary outcome was poor neurological outcome at 3 months (defined as cerebral performance categories 3–5). We analysed 46 CE-MRI brain scans (27 patients). Of these, 15 (55.6%) patients had poor neurological outcomes. Poor neurological outcome group patients showed a significantly higher proportion of pBD than those in the good neurological outcome group (22 (88%) vs. 6 (28.6%) patients, respectively, p < 0.001) and a higher sBD (5.0 (4.0–5.0) vs. 0.0 (0.0–1.0) patients, p < 0.001). Poor neurological outcome predictions showed that the sBD had a significantly better prognostic performance (area under the curve (AUC) 0.95, 95% confidence interval (CI) 0.84–0.99) than the pBD (AUC 0.80, 95% CI 0.65–0.90). The sBD cut-off value was >1 point (sensitivity, 96.0%; specificity, 81.0%). The sBD is a highly predictive and sensitive marker of 3-month poor neurological outcome in OHCA survivors. Multicentre prospective studies are required to determine the generalisability of these results.

scholarly journals Post-resuscitation partial pressure of arterial carbon dioxide and outcome in patients with out-of-hospital cardiac arrest: a multicenter retrospective cohort study

2021 ◽  
Author(s):  
Nobunaga Okada ◽  
Tasuku Matsuyama ◽  
Yohei Okada ◽  
Asami Okada ◽  
Kenji Kandori ◽  
...  
Keyword(s):  
Cardiac Arrest ◽  
Neurological Outcome ◽  
Cerebral Performance Category ◽  
Multivariate Logistic Regression Analysis ◽  
Spontaneous Circulation ◽  
Performance Category ◽  
Neurological Outcomes ◽  
Significant Difference ◽  
Poor Neurological Outcome ◽  
Hospital Cardiac Arrest

Abstract We aimed to estimate the association between PaCO2 level in the patient after out-of-hospital cardiac arrest (OHCA) resuscitation with patient outcome based on a multicenter prospective cohort registry in Japan between June 2014 and December 2015.Based on the PaCO2 within 24-h after return of spontaneous circulation (ROSC), patients were divided into six groups as follow; severe hypocapnia (<25mmHg), mild hypocapnia (25–35mmHg,), normocapnia (35–45mmHg), mild hypercapnia (45–55mmHg), severe hypercapnia (>55mmHg), exposure to both hypocapnia and hypercapnia. Multivariate logistic regression analysis was conducted to calculate the adjusted odds ratios (aORs) and 95% confidence interval (CI) for the 1-month poor neurological outcome (Cerebral Performance Category ≥3). Among the 13491 OHCA patients, 607 were included. Severe hypocapnia, mild hypocapnia, severe hypercapnia, and exposure to both hypocapnia and hypercapnia were associated with a higher rate of 1-month poor neurological outcome compared with mild hypercapnia (aOR 6.68 [95% CI 2.16–20.67], 2.56 [1.30–5.04], 2.62 [1.06–6.47], 5.63 [2.21–14.34]; respectively). There was no significant difference between the outcome of patients with normocapnia and mild hypercapnia. In conclusion, maintaining normocapnia and mild hypercapnia during the 24-h after ROSC was associated with better neurological outcomes than other PaCO2 abnormalities in this study.

scholarly journals A Human Thermoregulation Simulator for Calibrating Water-Perfused Cooling Pad Systems for Therapeutic Hypothermia

2017 ◽  
Vol 11 (3) ◽  
Author(s):  
Priya S. E. Chacko ◽  
Ali Seifi ◽  
Kenneth R. Diller
Keyword(s):  
Therapeutic Hypothermia ◽  
Core Temperature ◽  
Convective Transport ◽  
The Body ◽  
Body Core Temperature ◽  
Temperature Management ◽  
Thermal Mass ◽  
The Core ◽  
Highly Nonlinear ◽  
Human Thermoregulation

The induction of a mild reduction in body core temperature has been demonstrated to provide neuroprotection for patients who have suffered a medical event resulting in ischemia to the brain or vital organs. Temperatures in the range of 32–34 °C provide the required level of protection and can be produced and maintained by diverse means for periods of days. Rewarming from hypothermia must be conducted slowly to avoid serious adverse consequences and usually is performed under control of the thermal therapeutic device based on a closed-loop feedback strategy based on the patient's core temperature. Given the sensitivity and criticality of this process, it is important that the device control system be able to interact with the human thermoregulation system, which itself is highly nonlinear. The therapeutic hypothermia device must be calibrated periodically to ensure that its performance is accurate and safe for the patient. In general, calibration processes are conducted with the hypothermia device operating on a passive thermal mass that behaves much differently than a living human. This project has developed and demonstrated an active human thermoregulation simulator (HTRS) that embodies major governing thermal functions such as central metabolism, tissue conduction, and convective transport between the core and the skin surface via the flow of blood and that replicates primary dimensions of the torso. When operated at physiological values for metabolism and cardiac output, the temperature gradients created across the body layers and the heat exchange with both an air environment and a clinical water-circulating cooling pad system match that which would occur in a living body. Approximately two-thirds of the heat flow between the core and surface is via convection rather than conduction, highlighting the importance of including the contribution of blood circulation to human thermoregulation in a device designed to calibrate the functioning of a therapeutic hypothermia system. The thermoregulation simulator functions as anticipated for a typical living patient during both body cooling and warming processes. This human thermoregulatory surrogate can be used to calibrate the thermal function of water-perfused cooling pads for a hypothermic temperature management system during both static and transient operation.

scholarly journals Prognostic Value of Muscle Mass Measured via Brain Computed Tomography in Neurocritically Ill Patients

2020 ◽  
Author(s):  
Yun Im Lee ◽  
Ryoung-Eun Ko ◽  
Joonghyun Ahn ◽  
Keumhee C. Carriere ◽  
Jeong-Am Ryu
Keyword(s):  
Computed Tomography ◽  
Skeletal Muscle ◽  
Muscle Mass ◽  
Neurological Outcome ◽  
Skeletal Muscle Mass ◽  
Brain Computed Tomography ◽  
Brain Ct ◽  
Neurological Outcomes ◽  
Poor Neurological Outcome

Abstract Background To investigate whether skeletal muscle mass estimated via brain computed tomography (CT) can be used to predict neurological outcomes in neurocritically ill patients. Methods This is a retrospective, observational study. Adult patients who were admitted to the neurosurgical intensive care unit (ICU) in tertiary hospital from January 2010 to September 2019 were eligible. We included patients who were hospitalized in the neurosurgical ICU for more than 7 days. Cross-sectional areas of paravertebral muscle at the first cervical vertebra level (C1-CSA) and temporalis muscle thickness (TMT) on brain CT were measured to evaluate skeletal muscle mass. Primary outcome was Glasgow Outcome Scale score at 3 months. Results Among 189 patients, 167 (88.4%) survived until discharge from the hospital. Of these survivors, 81 (42.9%) patients had favorable neurologic outcomes. Initial TMT values and follow-up TMT values were higher in patients with favorable neurologic outcome compared to those with poor neurological outcome (p = 0.003 and p = 0.001, respectively). Initial the C1-CSA/body surface area was greater in patients with poor neurological outcome than in those with favorable outcome (p = 0.029). In multivariable analysis, age (adjusted odds ratio [OR]: 2.05, 95% confidence interval [CI]: 1.543–2.724), BMI (adjusted OR: 0.74, 95% CI: 0.638–0.849), use of mannitol (adjusted OR: 27.45, 95% CI: 4.833–155.860), change of C1-CSA (adjusted OR: 1.36, 95% CI: 1.054–1.761), and change of TMT (adjusted OR: 1.27, 95% CI: 1.028–1.576) were significantly associated with poor neurological outcome (Hosmer–Lemeshow test, Chi-square = 11.4, df = 8, p = 0.178) with the areas under curve of 0.803 (95% CI 0.740–0.866) using 10-fold cross validation method. Especially, the risk of poor neurologic outcome was proportional to changes of C1-CSA and TMT. Conclusions In this study, the follow-up skeletal muscle mass at first week from ICU admission, based on changes in C1-CSA and TMT, was associated with neurological prognosis in neurocritically ill patients. Eventually, brain CT-measured sarcopenia may be helpful in predicting poor neurological outcomes in these patients.

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