Acute cardiac care & resuscitation
Prediction of good functional outcome decreases diagnostic uncertainty in unconscious survivors after out-of-hospital cardiac arrest
Authors' conclusion
Raising the GCS-M inclusion threshold and adding favourable predictors to the 2021 ERC/ESICM prognostication algorithm reduced prognostic uncertainty without increasing falsely pessimistic predictions.
Study context
- Population
- Unconscious survivors after out-of-hospital cardiac arrest (TTM, TTM2, KORHN and ProNeCA studies)of whom 2,079 had Glasgow Coma Scale motor (GCS-M) < 4 at ≥ 72 h
- Participants
- 3,388 survivors
- Comparison
- 2021 ERC/ESICM algorithm vs Updated algorithm
- 2021 ERC/ESICM algorithmn = 2,079
- Updated algorithmn = 2,445
Primary result
As reported in the abstract
Poor functional outcome among patients identified by 2021 ERC/ESICM poor outcome criteria · six months
| Group | Value | Identified by poor outcome criteria | Specificity |
|---|---|---|---|
| 2021 ERC/ESICM algorithm | 870 events | 874 | 99.6% [95%CI 99.0-99.9] |
2021 ERC/ESICM algorithm
Value870 events
Identified by poor outcome criteria874
Specificity99.6% [95%CI 99.0-99.9]
Further findings
| Outcome | 2021 ERC/ESICM algorithm | Updated algorithm |
|---|---|---|
| Prognosticated patients with an indeterminate prognosis | 1,205/2,079 (58%) | 891/2,445 (36%) |
Poor outcome identification with GCS-M < 6 threshold
- More patients entered the algorithm
- 366
- More patients with poor outcomes identified, close to identical specificity
- Seven
Good functional outcome among patients identified by good outcome predictors · six months
- Patients with potential recovery identified
- 673
- Of those 673, good functional outcome
- 411 (61%)
Original publication
Prediction of good functional outcome decreases diagnostic uncertainty in unconscious survivors after out-of-hospital cardiac arrest. Resuscitation. Published 16 June 2025. doi:10.
Summarised from the published abstract; every number is checked against it