Cardiac arrest & resuscitation
Performance of the ERC/ESICM-recommendations for neuroprognostication after cardiac arrest: Insights from a prospective multicenter cohort
Authors' conclusion
All comatose resuscitated patients who fulfilled the ERC-ESICM criteria for poor outcome after CA had poor outcome at three months, even if a self-fulfilling prophecy cannot be completely excluded. In patients with indeterminate outcome (half of the population), favourable signs predicted neurological recovery, reducing prognostic uncertainty.
Study context
- Population
- OHCA survivors comatose (Glasgow Coma Scale motor score ≤3) at ≥72 h after resuscitation, 28 ICUs of the AfterROSC network
- Participants
- 337 participants
- Exposure
- 2021 ERC/ESICM neuroprognostication algorithm for predicting poor outcome after cardiac arrest (CA)
- Combination of 2 favourable signsn = 162
- Outcome
- Accuracy for predicting poor outcome (modified Rankin scale score ≥4)
- Follow-up
- 90 days
Methodological detailsmulticentre, 28 ICUs
- Multicentre
- 28 ICUs
Main finding
As reported in the abstract
Poor neurological outcome
| Group | Value | PPV |
|---|---|---|
| ERC-ESICM algorithm | 175 events | 100% [98-100]% |
ERC-ESICM algorithm
Value175 events
PPV100% [98-100]%
- Specificity of individual predictors ranged from 90% for EEG to 100% for clinical examination and SSEP
- 90%–100%
Observational data: associations, not effects.
Further findings
| Outcome | Combination of 2 favourable signs |
|---|---|
| Good outcome in patients with indeterminate outcome | |
| Specificity | 99[96-100]% |
| Sensitivity | 23[11-38]% |
Original publication
Performance of the ERC/ESICM-recommendations for neuroprognostication after cardiac arrest: Insights from a prospective multicenter cohort. Resuscitation. Published 14 August 2024. doi:10.
Composed by AI from the published abstract and checked against it. How Briefs are made →