• Norihiro Nishioka, Daisuke Kobayashi, Takeyuki Kiguchi, Taro Irisawa, Tomoki Yamada, Kazuhisa Yoshiya, Changhwi Park, Tetsuro Nishimura, Takuya Ishibe, Yoshiki Yagi, Masafumi Kishimoto, Sung-Ho Kim, Yasuyuki Hayashi, Taku Sogabe, Takaya Morooka, Haruko Sakamoto, Keitaro Suzuki, Fumiko Nakamura, Tasuku Matsuyama, Yohei Okada, Satoshi Matsui, Satoshi Yoshimura, Shunsuke Kimata, Shunsuke Kawai, Yuto Makino, Tetsuhisa Kitamura, Taku Iwami, and CRITICAL Study Group Investigators.
• Department of Preventive Services, Kyoto University School of Public Health, Kyoto, Japan.
• Resuscitation. 2021 Nov 1; 168: 142-150.

AimTo develop and validate a model for the early prediction of long-term neurological outcome in patients with non-traumatic out-of-hospital cardiac arrest (OHCA).MethodsWe analysed multicentre OHCA registry data of adult patients with non-traumatic OHCA who experienced return of spontaneous circulation (ROSC) and had been admitted to the intensive care unit between 2013 and 2017. We allocated 1329 (2013-2015) and 1025 patients (2016-2017) to the derivation and validation sets, respectively. The primary outcome was the dichotomized cerebral performance category (CPC) at 90 days, defined as good (CPC 1-2) or poor (CPC 3-5). We developed 2 models: model 1 included variables without laboratory data, and model 2 included variables with laboratory data available immediately after ROSC. Logistic regression with least absolute shrinkage and selection operator regularization was employed for model development. Measures of discrimination, accuracy, and calibration (C-statistics, Brier score, calibration plot, and net benefit) were assessed in the validation set.ResultsThe C-statistic (95% confidence intervals) of models 1 and 2 in the validation set was 0.947 (0.930-0.964) and 0.950 (0.934-0.966), respectively. The Brier score of models 1 and 2 in the validation set was 0.0622 and 0.0606, respectively. The calibration plot showed that both models were well-calibrated to the observed outcome. Decision curve analysis indicated that model 2 was similar to model 1.ConclusionThe prediction tool containing detailed in-hospital information showed good performance for predicting neurological outcome at 90 days immediately after ROSC in patients with OHCA.Copyright © 2021 Elsevier B.V. All rights reserved.

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