Work

Diagnostic yield and spectrum of head CT findings after return of spontaneous circulation in non-traumatic in-hospital cardiac arrest: a retrospective cohort study

Year: 2026

Type: article

Abstract: Objectives: To describe head computed tomography (CT) utilization and the diagnostic yield of acute intracranial pathology among adult survivors of non-traumatic in-hospital cardiac arrest (IHCA), and to identify factors associated with obtaining CT. Methods: We conducted a retrospective cohort study of adults with non-traumatic IHCA who achieved return of spontaneous circulation (ROSC) at a tertiary academic hospital between January 2019 and December 2024. Clinical characteristics, arrest variables, and radiologic findings were abstracted from the electronic medical record and institutional cardiac arrest registry. Acute intracranial pathology was categorized descriptively and included intracranial hemorrhage, hypoxic-ischemic brain injury (HIBI)-related cerebral edema (with or without sulcal or basilar cistern effacement), or other acute structural abnormalities. Multivariable logistic regression was used to evaluate predictors of CT utilization. Survival and neurological outcomes were assessed as exploratory, hypothesis-generating analyses. Results: Among 525 IHCA survivors, 89 (17%) underwent head CT. CT recipients were younger and more likely to have cerebrovascular disease or arrest in the emergency department. Intracranial hemorrhage was identified in 17% of scanned patients, while HIBI-related cerebral edema was present in 26%, with sulcal or cisternal effacement in 20% and 11%, respectively. CT utilization was not independently associated with survival or a favorable neurological outcome. Conclusion: Head CT after IHCA was used selectively but demonstrated a high diagnostic yield. The principal contribution of this study is the characterization of current imaging practices and the clinical profile of patients who undergo CT after IHCA. Further work is needed to define which patients may benefit most from early neuroimaging and whether imaging meaningfully alters management or decision-making.

Source: Resuscitation Plus

DOI: 10.1016/j.resplu.2026.101256