ArticleResuscitation2019
Distinct predictive values of current neuroprognostic guidelines in post-cardiac arrest patients.
Article in Resuscitation, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 23 papers, 4 of them syntheses that pooled it.
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
23 citing papers in PubMed, 4 syntheses or guidelines pooled it, 67 citations in OpenAlex.
- 2025 Korean Guidelines for Cardiopulmonary Resuscitation: Part 6. Post-cardiac arrest care.Clinical and experimental emergency medicine · 2026Guideline
- European Resuscitation Council and European Society of Intensive Care Medicine guidelines 2025: post-resuscitation care.Intensive care medicine · 2025Guideline
- 2020 Korean Guidelines for Cardiopulmonary Resuscitation. Part 5. Post-cardiac arrest care.Clinical and experimental emergency medicine · 2021Guideline
- Prediction of poor neurological outcome in comatose survivors of cardiac arrest: a systematic review.Intensive care medicine · 2020Pooled it
- Factors Associated with Early Withdrawal of Life-Sustaining Treatments After Out-of-Hospital Cardiac Arrest: A Subanalysis of a Randomized Trial of Prehospital Therapeutic Hypothermia.Neurocritical care · 2023Trial
- Neuroprognostication after cardiac arrest in patients without withdrawal of life-sustaining therapy: a prospective observational multicenter study.Critical care (London, England) · 2026Observational
- A machine learning framework for multimodal temporal prediction of neurological outcome after out-of-hospital cardiac arrest.Scientific reports · 2026Article
- Utility and rationale for continuous EEG monitoring: a primer for the general intensivist.Critical care (London, England) · 2024Review
- Normal value of neuron-specific enolase for predicting good neurological outcomes in comatose out-of-hospital cardiac arrest survivors.PloS one · 2024Observational
- Prognosis of consciousness disorders in the intensive care unit.Presse medicale (Paris, France : 1983) · 2023Review
- The SLANT Score Predicts Poor Neurologic Outcome in Comatose Survivors of Cardiac Arrest: An External Validation Using a Retrospective Cohort.Neurocritical care · 2023Article
- Prognostic accuracy of head computed tomography for prediction of functional outcome after out-of-hospital cardiac arrest: Rationale and design of the prospective TTM2-CT-substudy.Resuscitation plus · 2022Article
- Updates on Post-Resuscitation Care. After the Return of Spontaneous Circulation beyond the 2021 Guidelines.Reviews in cardiovascular medicine · 2022Review
- External validation of the 2020 ERC/ESICM prognostication strategy algorithm after cardiac arrest.Critical care (London, England) · 2022Article
- Brain injury after cardiac arrest: pathophysiology, treatment, and prognosis.Intensive care medicine · 2021Review
- Serum markers of brain injury can predict good neurological outcome after out-of-hospital cardiac arrest.Intensive care medicine · 2021Article
- Ultra-early serum concentrations of neuronal and astroglial biomarkers predict poor neurological outcome after out-of-hospital cardiac arrest-a pilot neuroprognostic study.Resuscitation plus · 2021Article
- European Resuscitation Council and European Society of Intensive Care Medicine guidelines 2021: post-resuscitation care.Intensive care medicine · 2021Article
- MRI in disorders of consciousness.Current opinion in neurology · 2020Review
- Adult Advanced Life Support: 2020 International Consensus on Cardiopulmonary Resuscitation and Emergency Cardiovascular Care Science with Treatment Recommendations.Resuscitation · 2020Article
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Authors and funding
6 authors at 3 institutions in 1 country.
Funding
Abstract
purposeTo assess the performance of neuroprognostic guidelines proposed by the American Academy of Neurology (AAN), European Resuscitation Council/European Society of Intensive Care Medicine (ERC/ESICM), and American Heart Association (AHA) in predicting outcomes of patients who remain unconscious after cardiac arrest.
methodsWe retrospectively identified a cohort of unconscious post-cardiac arrest patients at a single tertiary care centre from 2011 to 2017 and reviewed hospital records for clinical, radiographic, electrophysiologic, and biochemical findings. Outcomes at discharge and 6 months post-arrest were abstracted and dichotomized as good (Cerebral Performance Category (CPC) scores of 1-2) versus poor (CPC 3-5). Outcomes predicted by current guidelines were compared to actual outcomes, with false positive rate (FPR) used as a measure of predictive value.
resultsOf 226 patients, 36% survived to discharge, including 24 with good outcomes; 52% had withdrawal of life-sustaining therapies (WLST) during hospitalization. The AAN guideline yielded discharge and 6-month FPR of 8% and 15%, respectively. In contrast, the ERC/ESICM had a FPR of 0% at both discharge and 6 months. The AHA predictors had variable specificities, with diffuse hypoxic-ischaemic injury on MRI performing especially poorly (FPR 12%) at both discharge and 6 months.
conclusionsThough each guideline had components that performed well, only the ERC/ESICM guideline yielded a 0% FPR. Amongst the AAN and AHA guidelines, false positives emerged more readily at 6 months, reflective of continuing recovery after discharge, even in a cohort inevitably biased by WLST. Further assessment of predictive modalities is needed to improve neuroprognostic accuracy.
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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.