Perioperative medicine & outcomes
Prediction of Cardiopulmonary Resuscitation Outcomes for Arrest in Surgical Settings
Authors' conclusion
In this prospective prognostic study of outcomes following perioperative CPR, extreme gradient boosting generated individualized predictions of outcomes following perioperative CPR that may inform prevention strategies and goal-concordant surgical care.
Study context
- Population
- Adults ≥18 y undergoing noncardiac surgery who underwent cardiopulmonary resuscitation (CPR) on the day of surgery, ACS-NSQIP (nearly 700 US hospitals), 2012–2023
- Participants
- 6,405 adults
- Outcome
- 30-day mortality following CPR
- Follow-up
- 30 days
Methodological detailsprospective, multicentre, machine learning, 10-fold cross validation, internal validation
- Prospective
- Multicentre
- Machine learning
- 10-fold cross validation
- Internal validation
Performance
As reported in the abstract
30-day mortality prediction
| Test or model | AUC | Accuracy | Sensitivity | Specificity | Brier score |
|---|---|---|---|---|---|
| COMPASS | 0.80 (95 % CI, 0.78-0.82) | 0.73 (95% CI, 0.71-0.75) | 0.77 (95% CI, 0.74-0.79) | 0.68 (95% CI, 0.65-0.71) | 0.18 |
COMPASS
AUC0.80 (95 % CI, 0.78-0.82)
Accuracy0.73 (95% CI, 0.71-0.75)
Sensitivity0.77 (95% CI, 0.74-0.79)
Specificity0.68 (95% CI, 0.65-0.71)
Brier score0.18
- Died within 30 days
- 3710 (57.9%)
Secondary outcomes
| Outcome | Values |
|---|---|
| Nonhome discharge among survivors admitted from home | Extreme gradient boosting AUROC 0.78 (95 % CI, 0.74-0.82) · accuracy 0.76 · Brier score 0.17 |
- Nonhome discharge among survivors admitted from home — Survivors admitted from home discharged to a facility
- 822 (33.2%) of 2478
Key predictors (SHAP analysis)
- ASA status, case urgency and frailty identified as key predictors
Clinical utility (decision curve analysis (DCA))
- Greater net benefit of extreme gradient boosting over default strategies (treat all or treat none) across wide threshold ranges
Original publication
Prediction of Cardiopulmonary Resuscitation Outcomes for Arrest in Surgical Settings. JAMA Netw Open. Published 1 October 2025. doi:10.
Composed by AI from the published abstract and checked against it. How Briefs are made →