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Search: onr:"swepub:oai:DiVA.org:hb-29456" > Predicting survival...

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  • Hessulf, Fredrik,1986Gothenburg University,Göteborgs universitet,Institutionen för medicin, avdelningen för molekylär och klinisk medicin,Institute of Medicine, Department of Molecular and Clinical Medicine,Department of Molecular and Clinical Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden; Department of Anesthesiology and Intensive Care Medicine, Sahlgrenska University Hospital, Mölndal, Sweden (author)

Predicting survival and neurological outcome in out-of-hospital cardiac arrest using machine learning: the SCARS model

  • Article/chapterEnglish2023

Publisher, publication year, extent ...

  • Elsevier BV,2023
  • electronicrdacarrier

Numbers

  • LIBRIS-ID:oai:DiVA.org:hb-29456
  • https://urn.kb.se/resolve?urn=urn:nbn:se:hb:diva-29456URI
  • https://doi.org/10.1016/j.ebiom.2023.104464DOI
  • http://kipublications.ki.se/Default.aspx?queryparsed=id:152198237URI
  • https://lup.lub.lu.se/record/f2016067-4279-4a6b-8f2f-d0702d0d223dURI
  • https://gup.ub.gu.se/publication/324011URI

Supplementary language notes

  • Language:English
  • Summary in:English

Part of subdatabase

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  • Subject category:ref swepub-contenttype
  • Subject category:art swepub-publicationtype

Notes

  • Funding: Swedish Research Council (2019–02019); Swedish state under the agreement between the Swedish government, and the county councils (ALFGBG-971482); The Wallenberg Centre for Molecular and Translational Medicine
  • Background: A prediction model that estimates survival and neurological outcome in out-of-hospital cardiac arrest patients has the potential to improve clinical management in emergency rooms.Methods: We used the Swedish Registry for Cardiopulmonary Resuscitation to study all out-of-hospital cardiac arrest (OHCA) cases in Sweden from 2010 to 2020. We had 393 candidate predictors describing the circumstances at cardiac arrest, critical time intervals, patient demographics, initial presentation, spatiotemporal data, socioeconomic status, medications, and comorbidities before arrest. To develop, evaluate and test an array of prediction models, we created stratified (on the outcome measure) random samples of our study population. We created a training set (60% of data), evaluation set (20% of data), and test set (20% of data). We assessed the 30-day survival and cerebral performance category (CPC) score at discharge using several machine learning frameworks with hyperparameter tuning. Parsimonious models with the top 1 to 20 strongest predictors were tested. We calibrated the decision threshold to assess the cut-off yielding 95% sensitivity for survival. The final model was deployed as a web application.Findings: We included 55,615 cases of OHCA. Initial presentation, prehospital interventions, and critical time intervals variables were the most important. At a sensitivity of 95%, specificity was 89%, positive predictive value 52%, and negative predictive value 99% in test data to predict 30-day survival. The area under the receiver characteristic curve was 0.97 in test data using all 393 predictors or only the ten most important predictors. The final model showed excellent calibration. The web application allowed for near-instantaneous survival calculations.Interpretation: Thirty-day survival and neurological outcome in OHCA can rapidly and reliably be estimated during ongoing cardiopulmonary resuscitation in the emergency room using a machine learning model incorporating widely available variables.

Subject headings and genre

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  • Bhatt, Deepak L.Mount Sinai Heart, Icahn School of Medicine at Mount Sinai Health System, New York, NY, United States (author)
  • Engdahl, JohanUniversity of Gothenburg,Karolinska Institutet,Karolinska Institutet, Department of Medicine, Karolinska University Hospital Danderyd, Stockholm, Sweden (author)
  • Lundgren, PeterGothenburg University,Göteborgs universitet,University of Borås,Högskolan i Borås,Akademin för vård, arbetsliv och välfärd,a Department of Molecular and Clinical Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden; Department of Cardiology, Sahlgrenska University Hospital, Gothenburg, Sweden,Institutionen för medicin, avdelningen för molekylär och klinisk medicin,Institute of Medicine, Department of Molecular and Clinical Medicine(Swepub:gu)xlpetj (author)
  • Omerovic, Elmir,1968Gothenburg University,Göteborgs universitet,Institutionen för medicin, avdelningen för molekylär och klinisk medicin,Institute of Medicine, Department of Molecular and Clinical Medicine,Department of Molecular and Clinical Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden; Department of Cardiology, Sahlgrenska University Hospital, Gothenburg, Sweden; Wallenberg Laboratory for Cardiovascular and Metabolic Research, Institute of Medicine, University of Gothenburg, Gothenburg, Sweden(Swepub:gu)xomeel (author)
  • Rawshani, Aidin,1991Gothenburg University,Göteborgs universitet,University of Gothenburg,Institutionen för medicin, avdelningen för molekylär och klinisk medicin,Institute of Medicine, Department of Molecular and Clinical Medicine,Department of Molecular and Clinical Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden; Wallenberg Laboratory for Cardiovascular and Metabolic Research, Institute of Medicine, University of Gothenburg, Gothenburg, Sweden; The Lundberg Laboratory for Diabetes Research, Department of Molecular and Clinical Medicine, The Sahlgrenska Academy at the University of Gothenburg, Gothenburg, 413 45, Sweden(Swepub:gu)xrawai (author)
  • Helleryd, EdvinGothenburg University,Göteborgs universitet,University of Gothenburg,Institutionen för medicin, avdelningen för molekylär och klinisk medicin,Institute of Medicine, Department of Molecular and Clinical Medicine,a Department of Molecular and Clinical Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden (author)
  • Dworeck, ChristianGothenburg University,Göteborgs universitet,Institutionen för medicin, avdelningen för molekylär och klinisk medicin,Institute of Medicine, Department of Molecular and Clinical Medicine,Department of Molecular and Clinical Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden; Department of Cardiology, Sahlgrenska University Hospital, Gothenburg, Sweden(Swepub:gu)xdwoch (author)
  • Friberg, HansLund University,Lunds universitet,Anestesiologi och intensivvård,Sektion II,Institutionen för kliniska vetenskaper, Lund,Medicinska fakulteten,Centrum för hjärtstopp,Forskargrupper vid Lunds universitet,SWECRIT,Anesthesiology and Intensive Care,Section II,Department of Clinical Sciences, Lund,Faculty of Medicine,Center for cardiac arrest,Lund University Research Groups,Department of Clinical Sciences, Anesthesia & Intensive Care, Lund University, Skåne University Hospital, Malmö, Sweden(Swepub:lu)efor-hfr (author)
  • Redfors, BjörnGothenburg University,Göteborgs universitet,Institutionen för medicin, avdelningen för molekylär och klinisk medicin,Institute of Medicine, Department of Molecular and Clinical Medicine,Department of Molecular and Clinical Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden; Department of Cardiology, Sahlgrenska University Hospital, Gothenburg, Sweden; Wallenberg Laboratory for Cardiovascular and Metabolic Research, Institute of Medicine, University of Gothenburg, Gothenburg, Sweden(Swepub:gu)xredbj (author)
  • Nielsen, NiklasLund University,Lunds universitet,Centrum för hjärtstopp,Forskargrupper vid Lunds universitet,SEBRA Sepsis and Bacterial Resistance Alliance,Center for cardiac arrest,Lund University Research Groups,Department of Clinical Sciences, Anaesthesia and Intensive Care, Helsingborg Hospital, Lund University, Lund, Sweden(Swepub:lu)med-nni (author)
  • Myredal, AnnaGothenburg University,Göteborgs universitet,Institutionen för medicin, avdelningen för molekylär och klinisk medicin,Institute of Medicine, Department of Molecular and Clinical Medicine,a Department of Molecular and Clinical Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden; (author)
  • Frigyesi, AttilaLund University,Lunds universitet,Intensivvårdsepidemiologi,Forskargrupper vid Lunds universitet,Intensive Care Epidemiology,Lund University Research Groups,Department of Clinical Medicine, Anaesthesiology and Intensive Care, Lund University, Lund, SE-22185, Sweden(Swepub:lu)mats-afr (author)
  • Herlitz, Johan,1949-Gothenburg University,Göteborgs universitet,Högskolan i Borås,Akademin för vård, arbetsliv och välfärd,Department of Molecular and Clinical Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden,PreHospen,Institutionen för medicin, avdelningen för molekylär och klinisk medicin,Institute of Medicine, Department of Molecular and Clinical Medicine(Swepub:gu)xherjo (author)
  • Rawshani, Araz,1986Gothenburg University,Göteborgs universitet,Institutionen för medicin, avdelningen för molekylär och klinisk medicin,Institute of Medicine, Department of Molecular and Clinical Medicine,Department of Molecular and Clinical Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden; Department of Cardiology, Sahlgrenska University Hospital, Gothenburg, Sweden; The Wallenberg Centre for Molecular and Translational Medicine, University of Gothenburg, Gothenburg, Sweden(Swepub:gu)xrawar (author)
  • Göteborgs universitetInstitutionen för medicin, avdelningen för molekylär och klinisk medicin (creator_code:org_t)

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