{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,9]],"date-time":"2026-09-09T10:11:17Z","timestamp":1788948677219,"version":"build-2803163510"},"reference-count":23,"publisher":"MDPI AG","issue":"18","license":[{"start":{"date-parts":[[2026,9,9]],"date-time":"2026-09-09T00:00:00Z","timestamp":1788912000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100003725","name":"National Research Foundation of Korea","doi-asserted-by":"publisher","award":["NRF-2022R1I1A3063280"],"award-info":[{"award-number":["NRF-2022R1I1A3063280"]}],"id":[{"id":"10.13039\/501100003725","id-type":"DOI","asserted-by":"publisher"}]},{"award":["NRF-2022R1I1A3063280"],"award-info":[{"award-number":["NRF-2022R1I1A3063280"]}],"id":[{"id":"https:\/\/ror.org\/013aysd81","id-type":"ROR","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J. Clin. Med.","JCM"],"abstract":"<jats:p>Background: Single-time-point cerebrospinal fluid (CSF) volume proportion (pCSFV) has shown limited prognostic utility after out-of-hospital cardiac arrest (OHCA). We hypothesized that serial within-patient change in pCSFV (\u0394pCSFV), rather than absolute values, would reflect progression of neurologic injury. Methods: This retrospective 72\u201396-h landmark cohort study included comatose adult OHCA survivors who underwent brain computed tomography (CT) within 6 h (early) and at 72\u201396 h (delayed) after return of spontaneous circulation. pCSFV was quantified using Hounsfield-unit-based volumetry. \u0394pCSFV was calculated as delayed pCSFV minus early pCSFV. The primary outcome was poor 6-month neurologic outcome (Cerebral Performance Category 3\u20135). Results: Among 125 patients, 63 (50.4%) had poor neurologic outcomes. Early and delayed pCSFV did not differ significantly between outcome groups, whereas \u0394pCSFV was lower in the poor-outcome group (p &lt; 0.001). In the five-parameter multiple-imputation model, \u0394pCSFV was associated with poor outcome (adjusted odds ratio [aOR] 0.684 per 1 percentage-point increase, 95% confidence interval [CI] 0.494\u20130.947; p = 0.022), with a consistent result in the complete-case sensitivity analysis (aOR 0.648, 95% CI 0.446\u20130.940; p = 0.022). However, this association was attenuated after additional adjustment for early pCSFV (aOR 0.728, 95% CI 0.462\u20131.146; p = 0.170). Adding \u0394pCSFV to the baseline model did not significantly improve discrimination (area under the curve 0.962 vs. 0.955; p = 0.292). Conclusions: \u0394pCSFV may provide complementary information on serial CSF-space changes but should not be interpreted as a baseline-independent marker. These findings apply only to patients who survived and underwent delayed CT at 72\u201396 h. The observed data-derived cutoff is exploratory and requires external validation before any clinical application.<\/jats:p>","DOI":"10.3390\/jcm15186978","type":"journal-article","created":{"date-parts":[[2026,9,9]],"date-time":"2026-09-09T09:24:02Z","timestamp":1788945842000},"page":"6978","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Serial Changes in CSF Volume Proportion on Brain CT and 6-Month Neurologic Outcomes After Cardiac Arrest: A 72\u201396-h Landmark Cohort Study"],"prefix":"10.3390","volume":"15","author":[{"given":"Seungho","family":"Lee","sequence":"first","affiliation":[{"name":"Department of Emergency Medicine, College of Medicine, Chungnam National University, Daejeon 35015, Republic of Korea"},{"name":"Department of Emergency Medicine, Chungnam National University Hospital, Daejeon 35015, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"},{"role":"writing-original-draft","vocabulary":"credit"},{"role":"formal-analysis","vocabulary":"credit"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4283-5423","authenticated-orcid":false,"given":"Jung Soo","family":"Park","sequence":"additional","affiliation":[{"name":"Department of Emergency Medicine, College of Medicine, Chungnam National University, Daejeon 35015, Republic of Korea"},{"name":"Department of Emergency Medicine, Chungnam National University Hospital, Daejeon 35015, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"},{"role":"investigation","vocabulary":"credit"},{"role":"writing-original-draft","vocabulary":"credit"},{"role":"funding-acquisition","vocabulary":"credit"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3558-3691","authenticated-orcid":false,"given":"Hyonshik","family":"Ryu","sequence":"additional","affiliation":[{"name":"Department of Emergency Medicine, College of Medicine, Chungnam National University, Daejeon 35015, Republic of Korea"},{"name":"Department of Emergency Medicine, Chungnam National University Hospital, Daejeon 35015, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jin Hong","family":"Min","sequence":"additional","affiliation":[{"name":"Department of Emergency Medicine, College of Medicine, Chungnam National University, Daejeon 35015, Republic of Korea"},{"name":"Department of Emergency Medicine, Chungnam National University Hospital, Daejeon 35015, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"},{"role":"data-curation","vocabulary":"credit"},{"role":"formal-analysis","vocabulary":"credit"}]},{"given":"Changshin","family":"Kang","sequence":"additional","affiliation":[{"name":"Department of Emergency Medicine, College of Medicine, Chungnam National University, Daejeon 35015, Republic of Korea"},{"name":"Department of Emergency Medicine, Chungnam National University Hospital, Daejeon 35015, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"},{"role":"data-curation","vocabulary":"credit"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9105-1222","authenticated-orcid":false,"given":"Yeonho","family":"You","sequence":"additional","affiliation":[{"name":"Department of Emergency Medicine, College of Medicine, Chungnam National University, Daejeon 35015, Republic of Korea"},{"name":"Department of Emergency Medicine, Chungnam National University Hospital, Daejeon 35015, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"},{"role":"formal-analysis","vocabulary":"credit"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3571-9448","authenticated-orcid":false,"given":"Byung Kook","family":"Lee","sequence":"additional","affiliation":[{"name":"Department of Emergency Medicine, Chonnam National University Hospital, Chonnam National University Medical School, Gwangju 58128, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"},{"role":"writing-review-editing","vocabulary":"credit"}]}],"member":"1968","published-online":{"date-parts":[[2026,9,9]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"110809","DOI":"10.1016\/j.resuscitation.2025.110809","article-title":"European Resuscitation Council and European Society of Intensive Care Medicine guidelines 2025 Post-resuscitation care","volume":"215","author":"Nolan","year":"2025","journal-title":"Resuscitation"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"150","DOI":"10.1186\/s13054-018-2060-7","article-title":"Prognostication after cardiac arrest","volume":"22","author":"Sandroni","year":"2018","journal-title":"Crit. 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