Observational studyJournal of the American Heart Association2025
Clinical Prediction Score for Patients With Initial Nonshockable Rhythm Receiving Extracorporeal Cardiopulmonary Resuscitation for Out-of-Hospital Cardiac Arrest: Development and Internal Validation.
Observational study in Journal of the American Heart Association, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.
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Who cites it
4 citing papers in PubMed.
- Modelling eCPR eligibility after out-of-hospital cardiac arrest: a 10-year retrospective temporospatial analysis from a mixed urban-rural region in Germany.Scandinavian journal of trauma, resuscitation and emergency medicine · 2026Article
- External validation of ECPR prognostic models derived from pre-ECMO indicators in patients undergoing extracorporeal cardiopulmonary resuscitation.Resuscitation plus · 2026Article
- Impact of a clinical decision protocol on survival and neurological outcome following extracorporeal cardiopulmonary resuscitation.Journal of intensive care · 2026Article
- Scoring the Importance of Patient Selection in Extracorporeal Cardiopulmonary Resuscitation and Non-Shockable Rhythm Cardiac Arrest: The START-ECPR Score.Journal of the American Heart Association · 2025Article
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9 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundSelecting appropriate patients for extracorporeal cardiopulmonary resuscitation (ECPR) in cases of out-of-hospital cardiac arrest remains challenging, particularly for those with initial nonshockable rhythms. Our aim is to develop a prediction score to identify suitable ECPR candidates in patients with initial nonshockable rhythm.
methodsThe data were sourced from the SAVE-J II (Study of Advanced Life Support for Ventricular Fibrillation With Extracorporeal Circulation in Japan II) study, a retrospective multicenter observational study in Japan. Included were adult patients with out-of-hospital cardiac arrest who underwent ECPR with initial pulseless electrical activity or asystole. The primary outcome was survival to hospital discharge. We developed a prediction score, employing logistic regression analysis and internally validating it with 1000 bootstrap samples. The performance of the score in predicting a favorable neurological outcome at discharge was also evaluated.
resultsAmong 648 eligible patients, 86 (13.3%) survived to hospital discharge. The median age was 60.5 years, 75.9% (492) were male, and 74.4% (482) had pulseless electrical activity as the initial rhythm. Three clinical predictors for the START-ECPR Score (Signs of Life, Transient ROSC, Not Asystole Rhythm to ECPR Score) were identified: shockable rhythm or pulseless electrical activity at hospital arrival, transient return of spontaneous circulation before hospital arrival, and signs of life at hospital arrival. Survival rates were 4.4% (7/159) for a score of 0, 10.7% (38/356) for a score of 1, and 30.8% (39/130) for scores of 2 to -3. The bias-corrected C-index for the score was 0.696. For predicting favorable neurologic outcomes at discharge, the C-index was 0.761.
conclusionsWe developed a straightforward 3-factor prediction score for predicting survival to hospital discharge and favorable neurologic outcomes in patients with out-of-hospital cardiac arrest with initial nonshockable rhythms receiving ECPR.
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