Cardiac arrest & resuscitation
Development and validation of a novel score to predict brain death after out-of-hospital cardiac arrest
Authors' conclusion
The BDR score identifies those at highest risk for BD after OHCA.
Study context
- Population
- Successfully resuscitated out-of-hospital cardiac arrests (OHCA) patientsdevelopment cohort n = 362
- Exposure
- Development vs Validation
- Developmentn = 362
- Outcome
- Brain death (BD), predicted by BDR score (0–7 points: non-shockable rhythm, drug overdose aetiology, grey-white differentiation loss or sulcal effacement on head computed tomography (CT) within 24 h, Full-Outline-Of-UnResponsiveness (FOUR) score, age <45 years)
Methodological detailsprediction score development and validation, single academic centre development cohort, internal validation by k-fold cross validation (k = 8), external validation at an independent academic centre
- Prediction score development and validation
- Single academic centre development cohort
- Internal validation by k-fold cross validation (k = 8)
- External validation at an independent academic centre
Main finding
As reported in the abstract
BD prediction by BDR score
| Group | Value | AUC (internal validation) | Sensitivity (brain death risk (BDR) score >4) | Specificity (BDR score >4) | AUC |
|---|---|---|---|---|---|
| Development | 18% | 0.931 (95% CI 0.905-0.957) | 0.903 | 0.830 | |
| Validation | 19.8% | 0.882 | 0.652 | 0.849 (95% CI 0.765-0.933) |
Value
Development18%
Validation19.8%
AUC (internal validation)
Development0.931 (95% CI 0.905-0.957)
Validation— not stated in the abstract
Sensitivity (brain death risk (BDR) score >4)
Development0.903
Validation0.882
Specificity (BDR score >4)
Development0.830
Validation0.652
AUC
Development— not stated in the abstract
Validation0.849 (95% CI 0.765-0.933)
Observational data: associations, not effects.
Original publication
Development and validation of a novel score to predict brain death after out-of-hospital cardiac arrest. Resuscitation. Published 1 September 2023. doi:10.
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