Bayesian network predicted variables for good neurological outcomes in patients with out-of-hospital cardiac arrest

• Published in: PloS one Vol. 18; no. 9; p. e0291258
• Main Authors: Shinada, Kota, Matsuoka, Ayaka, Koami, Hiroyuki, Sakamoto, Yuichiro
• Format: Journal Article
• Language: English
• Published: San Francisco Public Library of Science 28.09.2023; Public Library of Science (PLoS)
• Subjects: Age; Analysis; Bayesian analysis; Bayesian statistical decision theory; Biology and Life Sciences; Cardiac arrest; Care and treatment; Computer and Information Sciences; Creatinine; Datasets; Decision making; Diagnosis; Emergency medical care; Epinephrine; Evaluation; Glasgow Coma Scale; Heart; Hospitals; Medical prognosis; Medicine; Medicine and Health Sciences; Nervous system diseases; Observational studies; Patient outcomes; Patients; People and Places; Physical Sciences; Potassium; Prognosis; Public health; Research and Analysis Methods; Rhythm; Risk factors; Sensitivity analysis; Survival; Variables; Japan; United Kingdom
• ISSN: 1932-6203; 1932-6203
• DOI: 10.1371/journal.pone.0291258

Out-of-hospital cardiac arrest (OHCA) is linked to a poor prognosis and remains a public health concern. Several studies have predicted good neurological outcomes of OHCA. In this study, we used the Bayesian network to identify variables closely associated with good neurological survival outcomes in patients with OHCA. This was a retrospective observational study using the Japan Association for Acute Medicine OHCA registry. Fifteen explanatory variables were used, and the outcome was one-month survival with Glasgow–Pittsburgh cerebral performance category (CPC) 1–2. The 2014–2018 dataset was used as training data. The variables selected were identified and a sensitivity analysis was performed. The 2019 dataset was used for the validation analysis. Four variables were identified, including the motor response component of the Glasgow Coma Scale (GCS M), initial rhythm, age, and absence of epinephrine. Estimated probabilities were increased in the following order: GCS M score: 2–6; epinephrine: non-administered; initial rhythm: spontaneous rhythm and shockable; and age: <58 and 59–70 years. The validation showed a sensitivity of 75.4% and a specificity of 95.4%. We identified GCS M score of 2–6, initial rhythm (spontaneous rhythm and shockable), younger age, and absence of epinephrine as variables associated with one-month survival with CPC 1–2. These variables may help clinicians in the decision-making process while treating patients with OHCA.