The association between the severity of out- of-hospital cardiac arrest and the effectiveness of target temperature management: a retrospective study based on prediction models
Dublin Core
Title
The association between the severity of out- of-hospital cardiac arrest and the effectiveness of target temperature management: a retrospective study based on prediction models
Subject
Out-of-hospital cardiac arrest, Return of spontaneous circulation, Prediction models, Severity, Target
temperature management
temperature management
Description
Abstract
Aim This study aimed to develop prediction models and conduct risk stratifications for patients with out-of-
hospital cardiac arrest (OHCA) to identify patients who could benefit from targeted temperature management
(TTM) at 33°C.
Methods A retrospective analysis was carried out on 368 patients and the primary outcome was the neurological
outcome at discharge evaluated by the Cerebral Performance Categories (CPC) scale. Six variables were utilized to
construct prediction models via six methodologies, and the Chi-square test or Fisher’s exact test was used to analyze
the efficacy of TTM at 33°C under diverse risk stratifications.
Results A total of 264 eligible patients were divided into the development cohort and test set. The identified
predictors comprised bystander cardiopulmonary resuscitation (CPR), pupillary light reflex, Acute Physiology and
Chronic Health Evaluation II (APACHE II) score, lactate, serum calcium (Ca2+), and base excess (BE). The AUC of different
prediction models in the test set ranged from 0.7592 to 0.9304. Patients with a predicted probability of 80-100%,
75-100%, and 67-100% in the Random Forest model, and 40-60% in the K-Nearest Neighbors model, can benefit
from 33°C TTM (OR [95% CI]: 3.21[1.44–7.19], 2.73[1.25–5.97], 2.18[1.09–4.36], 6.42[1.09–37.73], respectively). Among
patients who had successfully undergone TTM at 33 °C, there was a higher prevalence of patients classified as CPC 3
and CPC 4 and a lower incidence of those classified as CPC 5 (OR [95% CI]: 3.90[1.12–12.58], 2.29[1.24–4.26], 0.31[0.19–
0.51], respectively).
Conclusion Prediction models developed from early variables can predict the neurological prognosis of OHCA, and
the efficacy of 33°C TTM may be related to severity.
Aim This study aimed to develop prediction models and conduct risk stratifications for patients with out-of-
hospital cardiac arrest (OHCA) to identify patients who could benefit from targeted temperature management
(TTM) at 33°C.
Methods A retrospective analysis was carried out on 368 patients and the primary outcome was the neurological
outcome at discharge evaluated by the Cerebral Performance Categories (CPC) scale. Six variables were utilized to
construct prediction models via six methodologies, and the Chi-square test or Fisher’s exact test was used to analyze
the efficacy of TTM at 33°C under diverse risk stratifications.
Results A total of 264 eligible patients were divided into the development cohort and test set. The identified
predictors comprised bystander cardiopulmonary resuscitation (CPR), pupillary light reflex, Acute Physiology and
Chronic Health Evaluation II (APACHE II) score, lactate, serum calcium (Ca2+), and base excess (BE). The AUC of different
prediction models in the test set ranged from 0.7592 to 0.9304. Patients with a predicted probability of 80-100%,
75-100%, and 67-100% in the Random Forest model, and 40-60% in the K-Nearest Neighbors model, can benefit
from 33°C TTM (OR [95% CI]: 3.21[1.44–7.19], 2.73[1.25–5.97], 2.18[1.09–4.36], 6.42[1.09–37.73], respectively). Among
patients who had successfully undergone TTM at 33 °C, there was a higher prevalence of patients classified as CPC 3
and CPC 4 and a lower incidence of those classified as CPC 5 (OR [95% CI]: 3.90[1.12–12.58], 2.29[1.24–4.26], 0.31[0.19–
0.51], respectively).
Conclusion Prediction models developed from early variables can predict the neurological prognosis of OHCA, and
the efficacy of 33°C TTM may be related to severity.
Creator
Zhenyu Shan1
, Rui Shao1
, Xingsheng Wang1
, Guyu Zhang1
, Luying Zhang1
, Chenchen Hang1
, Le An1
, Jingfei Yu1
and
Ziren Tang1*
, Rui Shao1
, Xingsheng Wang1
, Guyu Zhang1
, Luying Zhang1
, Chenchen Hang1
, Le An1
, Jingfei Yu1
and
Ziren Tang1*
Date
2025
Contributor
Peri Irawan
Format
pdf
Language
english
Type
text
Files
Collection
Citation
Zhenyu Shan1
, Rui Shao1
, Xingsheng Wang1
, Guyu Zhang1
, Luying Zhang1
, Chenchen Hang1
, Le An1
, Jingfei Yu1
and
Ziren Tang1*, “The association between the severity of out- of-hospital cardiac arrest and the effectiveness of target temperature management: a retrospective study based on prediction models,” Repository Horizon University Indonesia, accessed April 22, 2026, https://repository.horizon.ac.id/items/show/13243.