Development of a Prompt Model for Predicting Neurological Outcomes in Patients with Return of Spontaneous Circulation from Out-of-hospital Cardiac Arrest

Overview

Journal Acute Med Surg

Specialty Critical Care

Date 2017 Nov 11

PMID 29123717

Citations 1

Authors

Kazumi Kumagai

Yasutaka Oda

Chiyomi Oshima

Tadashi Kaneko

Kotaro Kaneda

Yoshikatsu Kawamura

Yasuaki Ogino

Susumu Yamashita

Kiyoshi Ichihara

Tsuyoshi Maekawa

Ryosuke Tsuruta

Affiliations

Soon will be listed here.

Abstract

Aim: Early prediction of the neurological outcomes of patients with out-of-hospital cardiac arrest is important to select the optimal clinical management. We hypothesized that clinical data recorded at the site of cardiopulmonary resuscitation would be clinically useful.

Methods: This retrospective cohort study included patients with return of spontaneous circulation after cardiopulmonary resuscitation who were admitted to our university hospital between January 2000 and November 2013 or two affiliated hospitals between January 2006 and November 2013. Clinical parameters recorded on arrival included age (A), arterial blood pH (B), time from cardiopulmonary resuscitation to return of spontaneous circulation (C), pupil diameter (D), and initial rhythm (E). Glasgow Outcome Scale was recorded at 6 months and a favorable neurological outcome was defined as a score of 4-5 on the Glasgow Outcome Scale. Multiple logistic regression analysis was carried out to derive a formula to predict neurological outcomes based on basic clinical parameters.

Results: The regression equation was derived using a teaching dataset (total, = 477; favourable outcome, = 55): EP = 1/(1 + e ), where EP is the estimated probability of having a favorable outcome, and = (-0.023 × A) + (3.296 × B) - (0.070 × C) - (1.006 × D) + (2.426 × E) - 19.489. The sensitivity, specificity, and accuracy were 80%, 92%, and 90%, respectively, for the validation dataset (total, = 201; favourable outcome, = 25).

Conclusion: The 6-month neurological outcomes can be predicted in patients resuscitated from out-of-hospital cardiac arrest using clinical parameters that can be easily recorded at the site of cardiopulmonary resuscitation.

Citing Articles

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

Heo W, Jung Y, Lee H, Jeung K, Lee B, Youn C PLoS One. 2022; 17(4):e0265275.

PMID: 35363794 PMC: 8975166. DOI: 10.1371/journal.pone.0265275.

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