Department of Emergency Medicine, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, 222 Banpo-daero, Seocho-gu, Seoul, 137-701, Republic of Korea.
Department of Emergency Medicine, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, 222, Banpo-daero, Seocho-Gu, Seoul, 06591, Republic of Korea.
Crit Care. 2022 Apr 11;26(1):95. doi: 10.1186/s13054-022-03954-w.
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.
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.
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).
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.
评估 2020 年欧洲复苏委员会（ERC）和欧洲危重病医学会（ESICM）推荐的心脏骤停后（CA）预后策略算法的性能。
这是对韩国低温网络前瞻性登记 1.0 的回顾性分析。纳入无意识且在自主循环恢复（ROSC）后 4 天（72-96 小时）无混杂因素的患者。研究了预后策略算法中包含的预后因素与预后之间的关系，除肌阵挛状态和神经功能结局外。最后，评估预后策略算法的预后性能。预后不良定义为 ROSC 后 6 个月时脑功能分类 3-5 级。
最终分析共纳入 660 例患者。其中，108 例（16.4%）患者在 CA 后 6 个月时神经功能结局良好。2020 年 ERC/ESICM 预后策略算法在无意识或 GCS_M 评分≤3 分的患者中，预测预后不良的患者的灵敏度为 60.2%（95%CI 55.9-64.4），特异性为 100%（95%CI 93.9-100），在无意识患者中，灵敏度为 58.2%（95%CI 53.9-62.3），特异性为 100%（95%CI 96.6-100）。当结合两种预后因素时，任何预后因素组合的假阳性率（FPR）均为 0（无 PR/CR 和差 CT 组合的 95%CI 0-5.6，无 SSEP N20 和 NSE 60 组合的 95%CI 0-30.8）。
2020 年 ERC/ESICM 预后策略算法预测预后不良，无 FPR，灵敏度为 58.2-60.2%。ERC/ESICM 推荐的两种预测因子的任何组合均显示 FPR 为 0%。
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