Acute cardiac care & 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 return of spontaneous circulationresuscitated from OHCA with sustained return of spontaneous circulation, 1402 from EUCAR and 747 from GLOBAL-MIRACLE included in the final analysis · EUCAR 1,402 · GLOBAL-MIRACLE 747
- Participants
- 2,149 patients
- Comparison
- Pre-MIRACLE2 score for prediction of poor neurological outcome
- EUCARn = 1,402
- GLOBAL-MIRACLEn = 747
- Outcome
- poor neurological outcome (defined as Cerebral Performance Category 3-5)
- Follow-up
- At hospital discharge
Methodological detailsEUCAR Registry retrospectively analysed, GLOBAL-MIRACLE Registry, a prospective cohort
- EUCAR Registry retrospectively analysed
- GLOBAL-MIRACLE Registry, a prospective cohort
Performance
As reported in the abstract
Primary endpoint occurred in study cohort
54.4%
Area under the receiver operating curve (AUROC) of the Pre-MIRACLE2 score
0.85
95% CI 0.83, 0.87
Further findings
- Pre-MIRACLE2 performance in the prospective validation cohort (GLOBAL-MIRACLE)
- 0.85 (95% CI 0.82-0.88) · AUROC · calibration slope 1.11 (95% CI 0.95-1.29)
Parts of this Brief are withheld: the automatic checks could not confirm them against the abstract.
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.
Summarised from the published abstract; every number is checked against it