Acute cardiac care & resuscitation
A multimodal model integrating early clinical and biomarker data to predict 1-year outcomes after pediatric cardiac arrest
- planned analysis of the POCCA study
Authors' conclusion
Brain injury biomarkers and MRI Injury Score improved prognostic accuracy over clinical variables alone for 1-year outcome in the Outcomes Cohort. External validation is needed before these findings can inform clinical decision-making.
Study context
- Population
- Children aged 48 h-17 years with ICU admission after cardiac arrestenrolled children, 118 with day 1 biomarker data and clinical predictors formed the Outcomes Cohort · Outcomes Cohort 118
- Participants
- 163 children
- Comparison
- Clinical models with vs without brain injury biomarkers and MRI Injury Score
- Outcome
- Unfavorable outcome:
- Death
- Vineland Adaptive Behavior Scale <70
- Follow-up
- 1 year
Main finding
As reported in the abstract
Biomarkers improved model fit over clinical variables alone in the Outcomes Cohort (likelihood ratio tests (LRT) p)
p = 0.002
Biomarkers did not improve model fit in the full, imputed POCCA Cohort (LRT p)
p = 0.07
Further findings
Addition of MRI Injury Score
| Comparison | aOR (95% CI) | P value | |
|---|---|---|---|
| MRI Injury Score · improved predictive performance | 1.13 (1.03–1.24) | P = 0.016 | |
| 0.512Adjusted odds ratio (log scale) |
Discrimination and calibration of penalized regression model (highest among four approaches)
- optimism-corrected AUROC
- 0.868 [95% CI, 0.82-0.94]
- calibration intercept
- 0.050 [0.00-0.26]
- calibration slope
- 1.067 [1.00-1.47]
Original publication
A multimodal model integrating early clinical and biomarker data to predict 1-year outcomes after pediatric cardiac arrest. Resuscitation. Published 24 August 2026. doi:10.1016/j.resuscitation.2026.111278
Summarised from the published abstract; every number is checked against it