Cardiac arrest & resuscitation
2021 European Resuscitation Council/European Society of Intensive Care Medicine Algorithm for Prognostication of Poor Neurological Outcome After Cardiac Arrest—Can Entry Criteria Be Broadened?*
Authors' conclusion
The 2021 ERC/ESICM algorithm for neuroprognostication predicted poor neurologic outcome with a FPR of 0%. Broadening inclusion criteria to include all unconscious patients regardless of ongoing sedation identified an additional small number of patients with poor outcome but did not affect the FPR.
Study context
- Population
- Postcardiac arrest patients managed at targeted temperature 36°C, four ICUs, Skane, Sweden, 2014–2018218 unconscious at 72 h
- Participants
- 794 patients
- Exposure
- Original ERC/ESICM algorithm entry criteria vs broadened criteria
- GCS-M 1-3n = 163reference
- Outcome
- Poor outcome prediction
Methodological detailsmulticentre, observational
- Multicentre
- Observational
Main finding
As reported in the abstract
| Group | Value | False positive rate (FPR) | Sensitivity |
|---|---|---|---|
| GCS-M 1-3 | 115 events | 0% (95% CI, 0-79.4%) | 71.0% (95% CI, 63.6-77.4%) |
| Ongoing sedation | 13 events | 0% (95% CI, 0-65.8%) | 69.6% (95% CI, 62.6-75.8%) |
| GCS-M 1-5 | 1 events | 0% (95% CI, 0-22.8) | 62.9% (95% CI, 56.1-69.2) |
Value
GCS-M 1-3115 events
Ongoing sedation13 events
GCS-M 1-51 events
False positive rate (FPR)
GCS-M 1-30% (95% CI, 0-79.4%)
Ongoing sedation0% (95% CI, 0-65.8%)
GCS-M 1-50% (95% CI, 0-22.8)
Sensitivity
GCS-M 1-371.0% (95% CI, 63.6-77.4%)
Ongoing sedation69.6% (95% CI, 62.6-75.8%)
GCS-M 1-562.9% (95% CI, 56.1-69.2)
Observational data: associations, not effects.
Further findings
Mortality at follow-up
- Dead at follow-up
- 495
- Died after withdrawal of life-sustaining therapies
- 330 of 495
Parts of this Brief are withheld: the automatic checks could not confirm them against the abstract.
Original publication
2021 European Resuscitation Council/European Society of Intensive Care Medicine Algorithm for Prognostication of Poor Neurological Outcome After Cardiac Arrest—Can Entry Criteria Be Broadened?*. Crit Care Med. Published 7 December 2023. doi:10.
Composed by AI from the published abstract and checked against it. How Briefs are made →