Title: Predicting Neurologic Outcome in the Era of TTM
题目：目标体温治疗（TTM）中神经系统预后的预测
Author 作者: Michael Winters
翻译：葛赟 校正：肖锋

•Whether you target 36oC or 33oC, targeted temperature management (TTM) improves survival and long-term neurologic oucome in survivors of out-of-hospital cardiac arrest.
•无论你的目标体温是36℃或33℃，目标体温治疗（TTM）均能提高院外心脏骤停患者的生存率和长期神经系统的预后。
•TTM, however, can affect the accuracy and timing of commonly used tests to predict poor neurologic outcome.
•然而，目标体温治疗能影响通常使用的预测不良神经系统预后指标的精确度和检测时间。
•Golan, et al just published a meta-analysis evaluating the accuracy of select diagnostic tests to predict outcome in patients treated with TTM.
•Golan等发表的meta分析评估了几个判断预后的诊断性试验在目标体温治疗患者中的准确度。
◦20 studies (1,845 patients)
◦20个研究项目（1845例患者）
◦Most accurate tests to predict poor neurologic outcome were:
◦最准确的预测不良神经系统预后的试验为：
▪Bilaterally absent pupillary reflex (LR 10.45)
▪双测瞳孔反射消失（LR 10.45）
▪Bilaterally absent somatosensory-evoked potentials (LR 12.79)
▪双侧躯体感觉诱发电位丧失（LR 12.79）
▪
◦Specificity of tests improved when testing was delayed > 72 hours
◦当试验延迟＞72h时，其特异性将提高。
◦Other commonly used tests (i.e., corneal reflexes, GCS motor score, unfavorable EEG readings) had higher false positive rates and lower LRs
◦另外，通常使用的检查（如角膜反射，GCS评分，EEG数据）有更高的假阳性率和更低的LR。

References 参考文献：
Golan E, et al. Predicting neurologic outcome after targeted temperature management for cardiac arrest: Systematic review and meta-analysis. Crit Care Med 2014; 42:1919-30.