Predictive Model of Good Clinical Outcomes in Patients Undergoing Coronary Angiography after Out-of-Hospital Cardiac Arrest: A Prospective, Multicenter Observational Study Conducted by the Korean Cardiac Arrest Research Consortium

Abstract

This observational study aimed to develop novel nomograms that predict the benefits of coronary angiography (CAG) after resuscitating patients with out-of-hospital cardiac arrest (OHCA) regardless of the electrocardiography findings and to perform an external validation of these models. Data were extracted from a prospective, multicenter registry of resuscitated patients with OHCA (October 2015-June 2018). New nomograms were developed based on variables associated with survival discharge and neurologic outcomes; their analysis included 723 and 709 patients, respectively. Patient age (p < 0.001), prehospital defibrillation by emergency medical technicians (EMTs) (p = 0.003), prehospital return of spontaneous circulation (ROSC) (p = 0.02), and time from collapse to ROSC (p < 0.001) were associated with survival discharge. Patient age (p < 0.001), prehospital defibrillation by EMTs (p < 0.001), and time from collapse to ROSC (p < 0.001) were associated with neurologic outcomes. The new nomogram had a good predictive performance, with an area under the curve (AUC) of 0.8832 (95% confidence interval (CI): 0.8358-0.9305) for survival discharge and an AUC of 0.9048 (95% CI: 0.8627-0.9469) for neurologic outcomes. Novel nomograms that predict survival discharge and good neurological outcomes after CAG in patients with OHCA were developed and validated; they can be quickly and easily applied to identify patients who will benefit from CAG.