Pre-hospital neurological risk stratification at return of spontaneous circulation (ROSC) after out-of-hospital cardiac arrest

Abstract

BACKGROUND: Out-of-hospital cardiac arrest (OHCA) remains a global health burden where neurological injury sustained is a key predictor of mortality but there are challenges in early risk stratification. This study aims to derive the Pre-MIRACLE METHODS: To validate the Pre-MIRACLE RESULTS: From 1 May 2012 until 31 May 2023, 2149 patients were resuscitated from OHCA with sustained return of spontaneous circulation. After excluding patients who remained non-comatose following return of spontaneous circulation and those with incomplete scores, 1402 patients from EUCAR and 747 from GLOBAL-MIRACLE were included in the final analysis. The primary endpoint occurred in 54.4% of the study cohort. The performance of the Pre-MIRACLE CONCLUSION: The Pre-MIRACLE