• Samuel Harford, Houshang Darabi, Marina Del Rios, Somshubra Majumdar, Fazle Karim, Vanden Hoek Terry T Department of Emergency Medicine, University of Illinois at Chicago, Chicago, Illinois, United States., Kim Erwin, and Dennis P Watson.
• Department of Mechanical and Industrial Engineering, University of Illinois at Chicago, Chicago, Illinois, United States.
• Resuscitation. 2019 May 1; 138: 134-140.

BackgroundOut-of-hospital cardiac arrest (OHCA) affects nearly 400,000 people each year in the United States of which only 10% survive. Using data from the Cardiac Arrest Registry to Enhance Survival (CARES), and machine learning (ML) techniques, we developed a model of neurological outcome prediction for OHCA in Chicago, Illinois.MethodsRescue workflow data of 2639 patients with witnessed OHCA were retrieved from Chicago's CARES. An Embedded Fully Convolutional Network (EFCN) classification model was selected to predict the patient outcome (survival with good neurological outcomes or not) based on 27 input features with the objective of maximizing the average class sensitivity. Using this model, sensitivity analysis of intervention variables such as bystander cardiopulmonary resuscitation (CPR), targeted temperature management, and coronary angiography was conducted.ResultsThe EFCN classification model has an average class sensitivity of 0.825. Sensitivity analysis of patient outcome shows that an additional 33 patients would have survived with good neurological outcome if they had received lay person CPR in addition to CPR by emergency medical services and 88 additional patients would have survived if they had received the coronary angiography intervention.ConclusionsML modeling of the complex Chicago OHCA rescue system can predict neurologic outcomes with a reasonable level of accuracy and can be used to support intervention decisions such as CPR or coronary angiography. The discriminative ability of this ML model requires validation in external cohorts to establish generalizability.Copyright © 2019 Elsevier B.V. All rights reserved.

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