Cardiac arrest & resuscitation
Pre-hospital neurological risk stratification at return of spontaneous circulation (ROSC) after out-of-hospital cardiac arrest – the Pre-MIRACLE2 score
Authors' conclusion
The Pre-MIRACLE2 score has the potential to be an effective and pragmatic risk stratification tool for prediction of poor neurological outcome in patients with resuscitated OHCA of suspected cardiac aetiology in a pre-hospital environment or where pH cannot be measured.
Study context
- Population
- Comatose patients resuscitated from out-of-hospital cardiac arrest (OHCA) with sustained ROSC, EUCAR (2012–2021) and GLOBAL-MIRACLE (2022–2023) registries1,402 EUCAR, 747 GLOBAL-MIRACLE
- Participants
- 2,149 patients
- Outcome
- Poor neurological outcome (Cerebral Performance Category 3-5)
- Follow-up
- Hospital discharge
Methodological detailsretrospective registry cohort (EUCAR), prospective registry cohort (GLOBAL-MIRACLE)
- Retrospective registry cohort (EUCAR)
- Prospective registry cohort (GLOBAL-MIRACLE)
Performance
As reported in the abstract
| Test or model | Area under the receiver operating curve (AUROC) |
|---|---|
| Pre-MIRACLE2 | 0.85 (95% CI 0.83, 0.87) |
Pre-MIRACLE2
Area under the receiver operating curve (AUROC)0.85 (95% CI 0.83, 0.87)
- Primary endpoint occurrence in study cohort
- 54.4%
Further findings
Poor neurological outcome, prospective validation cohort (GLOBAL-MIRACLE) · hospital discharge
- AUROC
- 0.85 (95% CI 0.82-0.88)
- Calibration slope
- 1.11 (95% CI 0.95-1.29)
- Prospective cohort
Original publication
Pre-hospital neurological risk stratification at return of spontaneous circulation (ROSC) after out-of-hospital cardiac arrest – the Pre-MIRACLE2 score. Resuscitation. Published 30 June 2026. doi:10.
Composed by AI from the published abstract and checked against it. How Briefs are made →