External validation of the 2020 ERC/ESICM prognostication strategy algorithm after cardiac arrest
(2022) In Critical care (London, England) 26(1).- Abstract
PURPOSE: To assess the performance of the post-cardiac arrest (CA) prognostication strategy algorithm recommended by the European Resuscitation Council (ERC) and the European Society of Intensive Care Medicine (ESICM) in 2020. METHODS: This was a retrospective analysis of the Korean Hypothermia Network Prospective Registry 1.0. Unconscious patients without confounders at day 4 (72-96 h) after return of spontaneous circulation (ROSC) were included. The association between the prognostic factors included in the prognostication strategy algorithm, except status myoclonus and the neurological outcome, was investigated, and finally, the prognostic performance of the prognostication strategy algorithm was evaluated. Poor outcome was defined... (More)
PURPOSE: To assess the performance of the post-cardiac arrest (CA) prognostication strategy algorithm recommended by the European Resuscitation Council (ERC) and the European Society of Intensive Care Medicine (ESICM) in 2020. METHODS: This was a retrospective analysis of the Korean Hypothermia Network Prospective Registry 1.0. Unconscious patients without confounders at day 4 (72-96 h) after return of spontaneous circulation (ROSC) were included. The association between the prognostic factors included in the prognostication strategy algorithm, except status myoclonus and the neurological outcome, was investigated, and finally, the prognostic performance of the prognostication strategy algorithm was evaluated. Poor outcome was defined as cerebral performance categories 3-5 at 6 months after ROSC. RESULTS: A total of 660 patients were included in the final analysis. Of those, 108 (16.4%) patients had a good neurological outcome at 6 months after CA. The 2020 ERC/ESICM prognostication strategy algorithm identified patients with poor neurological outcome with 60.2% sensitivity (95% CI 55.9-64.4) and 100% specificity (95% CI 93.9-100) among patients who were unconscious or had a GCS_M score ≤ 3 and with 58.2% sensitivity (95% CI 53.9-62.3) and 100% specificity (95% CI 96.6-100) among unconscious patients. When two prognostic factors were combined, any combination of prognostic factors had a false positive rate (FPR) of 0 (95% CI 0-5.6 for combination of no PR/CR and poor CT, 0-30.8 for combination of No SSEP N20 and NSE 60). CONCLUSION: The 2020 ERC/ESICM prognostication strategy algorithm predicted poor outcome without an FPR and with sensitivities of 58.2-60.2%. Any combinations of two predictors recommended by ERC/ESICM showed 0% of FPR.
(Less)
- author
- Youn, Chun Song ; Park, Kyu Nam ; Kim, Soo Hyun ; Lee, Byung Kook ; Cronberg, Tobias LU ; Oh, Sang Hoon ; Jeung, Kyung Woon ; Cho, In Soo and Choi, Seung Pill
- author collaboration
- organization
- publishing date
- 2022-04
- type
- Contribution to journal
- publication status
- published
- subject
- keywords
- Cardiac arrest, Guideline algorithm, Outcome, Prognostic accuracy
- in
- Critical care (London, England)
- volume
- 26
- issue
- 1
- article number
- 95
- publisher
- BioMed Central (BMC)
- external identifiers
-
- scopus:85127839520
- pmid:35399085
- ISSN
- 1364-8535
- DOI
- 10.1186/s13054-022-03954-w
- language
- English
- LU publication?
- yes
- id
- 572808ea-ddbe-4a41-bc62-f26c75946035
- date added to LUP
- 2022-06-09 13:57:47
- date last changed
- 2024-06-13 15:48:17
@article{572808ea-ddbe-4a41-bc62-f26c75946035,
abstract = {{<p>PURPOSE: To assess the performance of the post-cardiac arrest (CA) prognostication strategy algorithm recommended by the European Resuscitation Council (ERC) and the European Society of Intensive Care Medicine (ESICM) in 2020. METHODS: This was a retrospective analysis of the Korean Hypothermia Network Prospective Registry 1.0. Unconscious patients without confounders at day 4 (72-96 h) after return of spontaneous circulation (ROSC) were included. The association between the prognostic factors included in the prognostication strategy algorithm, except status myoclonus and the neurological outcome, was investigated, and finally, the prognostic performance of the prognostication strategy algorithm was evaluated. Poor outcome was defined as cerebral performance categories 3-5 at 6 months after ROSC. RESULTS: A total of 660 patients were included in the final analysis. Of those, 108 (16.4%) patients had a good neurological outcome at 6 months after CA. The 2020 ERC/ESICM prognostication strategy algorithm identified patients with poor neurological outcome with 60.2% sensitivity (95% CI 55.9-64.4) and 100% specificity (95% CI 93.9-100) among patients who were unconscious or had a GCS_M score ≤ 3 and with 58.2% sensitivity (95% CI 53.9-62.3) and 100% specificity (95% CI 96.6-100) among unconscious patients. When two prognostic factors were combined, any combination of prognostic factors had a false positive rate (FPR) of 0 (95% CI 0-5.6 for combination of no PR/CR and poor CT, 0-30.8 for combination of No SSEP N20 and NSE 60). CONCLUSION: The 2020 ERC/ESICM prognostication strategy algorithm predicted poor outcome without an FPR and with sensitivities of 58.2-60.2%. Any combinations of two predictors recommended by ERC/ESICM showed 0% of FPR.</p>}},
author = {{Youn, Chun Song and Park, Kyu Nam and Kim, Soo Hyun and Lee, Byung Kook and Cronberg, Tobias and Oh, Sang Hoon and Jeung, Kyung Woon and Cho, In Soo and Choi, Seung Pill}},
issn = {{1364-8535}},
keywords = {{Cardiac arrest; Guideline algorithm; Outcome; Prognostic accuracy}},
language = {{eng}},
number = {{1}},
publisher = {{BioMed Central (BMC)}},
series = {{Critical care (London, England)}},
title = {{External validation of the 2020 ERC/ESICM prognostication strategy algorithm after cardiac arrest}},
url = {{http://dx.doi.org/10.1186/s13054-022-03954-w}},
doi = {{10.1186/s13054-022-03954-w}},
volume = {{26}},
year = {{2022}},
}