High resolution ECG-aided early prognostic model for comatose survivors of out of hospital cardiac arrest

J Electrocardiol. 2015 Jul-Aug;48(4):544-50. doi: 10.1016/j.jelectrocard.2015.04.003. Epub 2015 Apr 10.

Abstract

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.

Keywords: High resolution ECG; Out-of-hospital cardiac arrest; Outcome; Prediction-tool; Resuscitation.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Causality
  • Coma / diagnosis
  • Coma / mortality*
  • Coma / therapy*
  • Comorbidity
  • Electrocardiography / methods*
  • Electrocardiography / statistics & numerical data*
  • Female
  • Humans
  • Hypothermia, Induced / mortality
  • Incidence
  • Male
  • Out-of-Hospital Cardiac Arrest / diagnosis
  • Out-of-Hospital Cardiac Arrest / mortality*
  • Out-of-Hospital Cardiac Arrest / therapy*
  • Prognosis
  • Reproducibility of Results
  • Rewarming / mortality
  • Risk Assessment / methods
  • Sensitivity and Specificity
  • Slovenia / epidemiology
  • Survival Analysis
  • Survivors / statistics & numerical data
  • Treatment Outcome