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External validation of the 2020 ERC/ESICM prognostication strategy algorithm after cardiac arrest

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 Netw...

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Autores principales: Youn, Chun Song, Park, Kyu Nam, Kim, Soo Hyun, Lee, Byung Kook, Cronberg, Tobias, Oh, Sang Hoon, Jeung, Kyung Woon, Cho, In Soo, Choi, Seung Pill
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8996564/
https://www.ncbi.nlm.nih.gov/pubmed/35399085
http://dx.doi.org/10.1186/s13054-022-03954-w
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author Youn, Chun Song
Park, Kyu Nam
Kim, Soo Hyun
Lee, Byung Kook
Cronberg, Tobias
Oh, Sang Hoon
Jeung, Kyung Woon
Cho, In Soo
Choi, Seung Pill
author_facet Youn, Chun Song
Park, Kyu Nam
Kim, Soo Hyun
Lee, Byung Kook
Cronberg, Tobias
Oh, Sang Hoon
Jeung, Kyung Woon
Cho, In Soo
Choi, Seung Pill
author_sort Youn, Chun Song
collection PubMed
description 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. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s13054-022-03954-w.
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spelling pubmed-89965642022-04-12 External validation of the 2020 ERC/ESICM prognostication strategy algorithm after cardiac arrest Youn, Chun Song Park, Kyu Nam Kim, Soo Hyun Lee, Byung Kook Cronberg, Tobias Oh, Sang Hoon Jeung, Kyung Woon Cho, In Soo Choi, Seung Pill Crit Care Research 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. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s13054-022-03954-w. BioMed Central 2022-04-11 /pmc/articles/PMC8996564/ /pubmed/35399085 http://dx.doi.org/10.1186/s13054-022-03954-w Text en © The Author(s) 2022 https://creativecommons.org/licenses/by/4.0/Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) . The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/ (https://creativecommons.org/publicdomain/zero/1.0/) ) applies to the data made available in this article, unless otherwise stated in a credit line to the data.
spellingShingle Research
Youn, Chun Song
Park, Kyu Nam
Kim, Soo Hyun
Lee, Byung Kook
Cronberg, Tobias
Oh, Sang Hoon
Jeung, Kyung Woon
Cho, In Soo
Choi, Seung Pill
External validation of the 2020 ERC/ESICM prognostication strategy algorithm after cardiac arrest
title External validation of the 2020 ERC/ESICM prognostication strategy algorithm after cardiac arrest
title_full External validation of the 2020 ERC/ESICM prognostication strategy algorithm after cardiac arrest
title_fullStr External validation of the 2020 ERC/ESICM prognostication strategy algorithm after cardiac arrest
title_full_unstemmed External validation of the 2020 ERC/ESICM prognostication strategy algorithm after cardiac arrest
title_short External validation of the 2020 ERC/ESICM prognostication strategy algorithm after cardiac arrest
title_sort external validation of the 2020 erc/esicm prognostication strategy algorithm after cardiac arrest
topic Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8996564/
https://www.ncbi.nlm.nih.gov/pubmed/35399085
http://dx.doi.org/10.1186/s13054-022-03954-w
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