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Spectral analysis-based risk score enables early prediction of mortality and cerebral performance in patients undergoing therapeutic hypothermia for ventricular fibrillation and comatose status

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Spectral analysis-based risk score enables early prediction of mortality and cerebral performance in patients undergoing therapeutic hypothermia for ventricular fibrillation and comatose status

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dc.contributor.author Filgueiras-Rama, David es_ES
dc.contributor.author Calvo Saiz, Conrado Javier es_ES
dc.contributor.author Salvador-Montañés, Óscar es_ES
dc.contributor.author Cádenas, Rosalia es_ES
dc.contributor.author Ruiz-Cantador, Jose es_ES
dc.contributor.author Armada, Eduardo es_ES
dc.contributor.author Rey, Juan Ramón es_ES
dc.contributor.author Merino, J.L. es_ES
dc.contributor.author Peinado, Rafael es_ES
dc.contributor.author Pérez-Castellano, Nicasio es_ES
dc.contributor.author Pérez-Villacastín, Julián es_ES
dc.contributor.author Quintanilla, Jorge G. es_ES
dc.contributor.author Jiménez Serrano, Santiago es_ES
dc.contributor.author Castells, Francisco es_ES
dc.contributor.author Millet Roig, José es_ES
dc.date.accessioned 2016-05-26T15:00:14Z
dc.date.available 2016-05-26T15:00:14Z
dc.date.issued 2015-05-01
dc.identifier.issn 0167-5273
dc.identifier.uri http://hdl.handle.net/10251/64816
dc.description.abstract Background: Early prognosis in comatose survivors after cardiac arrest due to ventricular fibrillation (VF) is unreliable, especially in patients undergoing mild hypothermia. We aimed at developing a reliable risk-score to enable early prediction of cerebral performance and survival. Methods: Sixty-one out of 239 consecutive patients undergoing mild hypothermia after cardiac arrest, with eventual return of spontaneous circulation (ROSC), and comatose status on admission fulfilled the inclusion criteria. Background clinical variables, VF time and frequency domain fundamental variables were considered. The primary and secondary outcomes were a favorable neurological performance (FNP) during hospitalization and survival to hospital discharge, respectively. The predictive model was developed in a retrospective cohort (n = 32; September 2006 September 2011, 48.5 ± 10.5 months of follow-up) and further validated in a prospective cohort (n = 29; October 2011 July 2013, 5 ± 1.8 months of follow-up). Results: FNP was present in 16 (50.0%) and 21 patients (72.4%) in the retrospective and prospective cohorts, respectively. Seventeen (53.1%) and 21 patients (72.4%), respectively, survived to hospital discharge. Both outcomes were significantly associated (p < 0.001). Retrospective multivariate analysis provided a prediction model (sensitivity = 0.94, specificity = 1) that included spectral dominant frequency, derived power density and peak ratios between high and low frequency bands, and the number of shocks delivered before ROSC. Validation on the prospective cohort showed sensitivity = 0.88 and specificity = 0.91. A model-derived risk-score properly predicted 93% of FNP. Testing the model on follow-up showed a c-statistic ≥ 0.89. Conclusions: A spectral analysis-based model reliably correlates time-dependent VF spectral changes with acute cerebral injury in comatose survivors undergoing mild hypothermia after cardiac arrest. es_ES
dc.description.sponsorship the CNIC is supported by the Spanish Ministry of Economy and Competitiveness and the Pro-CNIC Foundation. en_EN
dc.language Inglés es_ES
dc.publisher Elsevier es_ES
dc.relation Spanish Ministry of Economy and Competitiveness es_ES
dc.relation Pro-CNIC Foundation es_ES
dc.relation.ispartof International Journal of Cardiology es_ES
dc.rights Reserva de todos los derechos es_ES
dc.subject Cardiac arrest es_ES
dc.subject Cerebral injury es_ES
dc.subject Early prognosis es_ES
dc.subject Ventricular fibrillation es_ES
dc.subject Dominant frequency es_ES
dc.subject.classification TECNOLOGIA ELECTRONICA es_ES
dc.title Spectral analysis-based risk score enables early prediction of mortality and cerebral performance in patients undergoing therapeutic hypothermia for ventricular fibrillation and comatose status es_ES
dc.type Artículo es_ES
dc.identifier.doi 10.1016/j.ijcard.2015.03.074
dc.rights.accessRights Abierto es_ES
dc.contributor.affiliation Universitat Politècnica de València. Instituto Universitario de Aplicaciones de las Tecnologías de la Información - Institut Universitari d'Aplicacions de les Tecnologies de la Informació es_ES
dc.contributor.affiliation Universitat Politècnica de València. Departamento de Ingeniería Electrónica - Departament d'Enginyeria Electrònica es_ES
dc.description.bibliographicCitation Filgueiras-Rama, D.; Calvo Saiz, CJ.; Salvador-Montañés, Ó.; Cádenas, R.; Ruiz-Cantador, J.; Armada, E.; Rey, JR.... (2015). Spectral analysis-based risk score enables early prediction of mortality and cerebral performance in patients undergoing therapeutic hypothermia for ventricular fibrillation and comatose status. International Journal of Cardiology. 186:250-258. doi:10.1016/j.ijcard.2015.03.074 es_ES
dc.description.accrualMethod S es_ES
dc.relation.publisherversion http://dx.doi.org/10.1016/j.ijcard.2015.03.074 es_ES
dc.description.upvformatpinicio 250 es_ES
dc.description.upvformatpfin 258 es_ES
dc.type.version info:eu-repo/semantics/publishedVersion es_ES
dc.description.volume 186 es_ES
dc.relation.senia 290916 es_ES
dc.identifier.pmcid PMC5568426 en_EN


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