Prediction of Awakening after Out-of-Hospital Cardiac Arrest

W. T. Longstreth, Paula Diehr, Thomas S. Inui

Research output: Contribution to journalArticle

213 Citations (Scopus)

Abstract

To develop a model that would forecast neurologic recovery after out-of-hospital cardiac arrest, we reviewed charts on 389 consecutive patients who were not awake on admission to the hospital after resuscitation from asystole or ventricular fibrillation. The outcome variable was “awakening,” which was defined as having comprehensible speech or the ability to follow commands. Predictor variables that we considered included both preadmission and admission data. Using discriminant analysis, we derived models from a 60 per cent random sample of cases and tested the models on the remaining 40 per cent. We judged that the best model contained four variables from the admission examination: motor response, pupillary light response, spontaneous eye movements, and blood glucose (levels below 300 mg per deciliter predicted awakening). Overall correct classification was 80 per cent in the derivation sample and 77 per cent in the test sample. In a simplified form, the model's predictions of awakening had a sensitivity of 0.92, a specificity of 0.65, a positive predictive value of 0.80, and a negative predictive value of 0.84. This rule should be clinically useful in estimating the neurologic prognosis of patients resuscitated after out-of-hospital cardiac arrest. (N Engl J Med 1983; 308:1378–82.).

Original languageEnglish (US)
Pages (from-to)1378-1382
Number of pages5
JournalNew England Journal of Medicine
Volume308
Issue number23
DOIs
StatePublished - Jun 9 1983

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Out-of-Hospital Cardiac Arrest
Nervous System
Aptitude
Discriminant Analysis
Ventricular Fibrillation
Eye Movements
Heart Arrest
Resuscitation
Blood Glucose
Light

ASJC Scopus subject areas

  • Medicine(all)

Cite this

Prediction of Awakening after Out-of-Hospital Cardiac Arrest. / Longstreth, W. T.; Diehr, Paula; Inui, Thomas S.

In: New England Journal of Medicine, Vol. 308, No. 23, 09.06.1983, p. 1378-1382.

Research output: Contribution to journalArticle

Longstreth, W. T. ; Diehr, Paula ; Inui, Thomas S. / Prediction of Awakening after Out-of-Hospital Cardiac Arrest. In: New England Journal of Medicine. 1983 ; Vol. 308, No. 23. pp. 1378-1382.
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