Development of a prompt model for predicting neurological outcomes in patients with return of spontaneous circulation from out‐of‐hospital cardiac arrest

Kumagai, Kazumi; Oda, Yasutaka; Oshima, Chiyomi; Kaneko, Tadashi; Kaneda, Kotaro; Kawamura, Y.; Ogino, Yasuaki; Yamashita, Susumu; Ichihara, Kiyoshi; Maekawa, Taira; Tsuruta, Ryosuke

doi:10.1002/ams2.96

Cited by 2 publications

(2 citation statements)

References 26 publications

(51 reference statements)

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“…Further studies are required to evaluate this. Third, we could not evaluate several cardiac arrest-specific prognostication scores that required variables unavailable from our registry data [19,[30][31][32]. Lastly, the treating physicians were not blinded to the constituent results of the prognostication scores, thereby introducing the potential for self-fulfilling prophecy bias.…”

Section: Plos Onementioning

confidence: 99%

External validation of cardiac arrest-specific prognostication scores developed for early prognosis estimation after out-of-hospital cardiac arrest in a Korean multicenter cohort

et al. 2022

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We evaluated the performance of cardiac arrest-specific prognostication scores developed for outcome prediction in the early hours after out-of-hospital cardiac arrest (OHCA) in predicting long-term outcomes using independent data. The following scores were calculated for 1,163 OHCA patients who were treated with targeted temperature management (TTM) at 21 hospitals in South Korea: OHCA, cardiac arrest hospital prognosis (CAHP), C-GRApH (named on the basis of its variables), TTM risk, 5-R, NULL-PLEASE (named on the basis of its variables), Serbian quality of life long-term (SR-QOLl), cardiac arrest survival, revised post-cardiac arrest syndrome for therapeutic hypothermia (rCAST), Polish hypothermia registry (PHR) risk, and PROgnostication using LOGistic regression model for Unselected adult cardiac arrest patients in the Early stages (PROLOGUE) scores and prediction score by Aschauer et al. Their accuracies in predicting poor outcome at 6 months after OHCA were determined using the area under the receiver operating characteristic curve (AUC) and calibration belt. In the complete-case analyses, the PROLOGUE score showed the highest AUC (0.923; 95% confidence interval [CI], 0.904–0.941), whereas the SR-QOLl score had the lowest AUC (0.749; 95% CI, 0.711–0.786). The discrimination performances were similar in the analyses after multiple imputation. The PROLOGUE, TTM risk, CAHP, NULL-PLEASE, 5-R, and cardiac arrest survival scores were well calibrated. The rCAST and PHR risk scores showed acceptable overall calibration, although they showed miscalibration under the 80% CI level at extreme prediction values. The OHCA score, C-GRApH score, prediction score by Aschauer et al., and SR-QOLl score showed significant miscalibration in both complete-case (P = 0.026, 0.013, 0.005, and < 0.001, respectively) and multiple-imputation analyses (P = 0.007, 0.018, < 0.001, and < 0.001, respectively). In conclusion, the discrimination performances of the prognostication scores were all acceptable, but some showed significant miscalibration.

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Section: Plos Onementioning

confidence: 99%

External validation of cardiac arrest-specific prognostication scores developed for early prognosis estimation after out-of-hospital cardiac arrest in a Korean multicenter cohort

et al. 2022

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“…The authors reported a sensitivity of 80% and specificity of 92% for predicting 6-month neurologic outcome. 19 For OHCA of presumed cardiac origin, another model included variables such as age, time from collapse to ROSC, and ROSC prior to arrival at the hospital. 20 Summary Current evidence indicates which patients may not be good candidates for TTM, such as patients with a GWR ≤1.14 or rSO2 ≤40.…”

Section: Cbf and Metabolismmentioning

confidence: 99%

Critical Care Management Focused on Optimizing Brain Function After Cardiac Arrest

Nakashima

Hifumi

Kawakita

et al. 2017

Circ J

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The discussion of neurocritical care management in post-cardiac arrest syndrome (PCAS) has generally focused on target values used for targeted temperature management (TTM). There has been less attention paid to target values for systemic and cerebral parameters to minimize secondary brain damage in PCAS. And the neurologic indications for TTM to produce a favorable neurologic outcome remain to be determined. Critical care management of PCAS patients is fundamental and essential for both cardiologists and general intensivists to improve neurologic outcome, because definitive therapy of PCAS includes both special management of the cause of cardiac arrest, such as coronary intervention to ischemic heart disease, and intensive management of the results of cardiac arrest, such as ventilation strategies to avoid brain ischemia. We reviewed the literature and the latest research about the following issues and propose practical care recommendations. Issues are (1) prediction of TTM candidate on admission, (2) cerebral blood flow and metabolism and target value of them, (3) seizure management using continuous electroencephalography, (4) target value of hemodynamic stabilization and its method, (5) management and analysis of respiration, (6) sedation and its monitoring, (7) shivering control and its monitoring, and (8) glucose management. We hope to establish standards of neurocritical care to optimize brain function and produce a favorable neurologic outcome.

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Development of a prompt model for predicting neurological outcomes in patients with return of spontaneous circulation from out‐of‐hospital cardiac arrest

Cited by 2 publications

References 26 publications

External validation of cardiac arrest-specific prognostication scores developed for early prognosis estimation after out-of-hospital cardiac arrest in a Korean multicenter cohort

External validation of cardiac arrest-specific prognostication scores developed for early prognosis estimation after out-of-hospital cardiac arrest in a Korean multicenter cohort

Critical Care Management Focused on Optimizing Brain Function After Cardiac Arrest

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