High resolution ECG-aided early prognostic model for comatose survivors of out of hospital cardiac arrest.
Out of hospital cardiac arrest (OHCA) has a high mortality despite modern treatment. Reliable early prognosis in OHCA could significantly improve clinical decision making. We explored prognostic utility of advanced ECG parameters, obtained from high-resolution ECG, in combination with clinical and OHCA-related parameters during treatment with mild induced hypothermia (MIH) and after rewarming in unconscious survivors of OHCA. Ninety-two patients during MIH and 66 after rewarming were included. During MIH, a score based on initial rhythm, QRS-upslope and systolic pressure resulted in an area under curve (AUC) of 0.82 and accuracy of 80% for survival. After rewarming, a score based on admission rhythm, sum of 12 lead QRS voltages, and mean lateral ST segment level in leads I and V6 resulted in an AUC of 0.88 and accuracy of 85% for survival. ECG can assist with early prognostication in unconscious survivors of OHCA during MIH and after rewarming.
University of Ljubljana, Faculty of Medicine, Ljubljana, Slovenia.
Martin
M
Rauber
University of Ljubljana, Faculty of Medicine, Ljubljana, Slovenia; Centre for Intensive Internal Medicine, University Medical Centre, Ljubljana, Slovenia.
Dušan
D
Štajer
University of Ljubljana, Faculty of Medicine, Ljubljana, Slovenia; Centre for Intensive Internal Medicine, University Medical Centre, Ljubljana, Slovenia.
Marko
M
Noč
Department of Clinical Physiology, Karolinska Institutet, Stockholm, Sweden; and Nicollier-Schlegel Sàrl, Trélex, Switzerland.
Todd T
TT
Schlegel
University of Ljubljana, Faculty of Medicine, Ljubljana, Slovenia. Electronic address: vito.starc@mf.uni-lj.si.
Vito
V
Starc
D015984:Causality; D003128:Coma / Q000175:diagnosis / Q000401:mortality* / Q000628:therapy*; D015897:Comorbidity; D004562:Electrocardiography / Q000379:methods* / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D007036:Hypothermia, Induced / Q000401:mortality; D015994:Incidence; D008297:Male; D058687:Out-of-Hospital Cardiac Arrest / Q000175:diagnosis / Q000401:mortality* / Q000628:therapy*; D011379:Prognosis; D015203:Reproducibility of Results; D017694:Rewarming / Q000401:mortality; D018570:Risk Assessment / Q000379:methods; D012680:Sensitivity and Specificity; D017524:Slovenia / Q000453:epidemiology; D016019:Survival Analysis; D017741:Survivors / Q000706:statistics & numerical data; D016896:Treatment Outcome
High resolution ECG; Out-of-hospital cardiac arrest; Outcome; Prediction-tool; Resuscitation