The Prediction of Early Neurological Outcomes in Out-of-Hospital Cardiac Arrest Patients: A Multicenter Prospective Cohort Study by the KORHN Registry
Year: 2025
Type: article
Study design: Observational Study
Abstract: Background/Objectives: Early neuroprognostication after cardiac arrest is essential for guiding treatment strategies and providing accurate prognostic information to families. While several early risk scores have been proposed, few have incorporated a wide range of variables in large cohorts. This study aimed to develop and validate a novel prognostic model, the KORHN risk score, and to compare its performance with established tools including MIRACLE, TTM, CAHP, C-GRApH, and OHCA scores; Methods: We conducted a prospective multicenter observational study using data from the KORean Hypothermia Network registry. Risk variables identified in previous studies, along with extensive data from 1371 patients in the KORHN registry, were analyzed. The primary endpoint was poor neurological outcome at 6 months; Results: Key predictors included low-flow time, diastolic shock index, cardiac etiology, bilateral absence of pupil reflex, shockable initial rhythm, Glasgow Coma Scale motor response, epinephrine use, and age. Compared with established risk scores, the KORHN score demonstrated superior performance (AUC 0.925 vs. 0.827–0.902 with all variables, and AUC 0.914 vs. 0.85–0.903 with the top five variables with identical cut-off). External validation in a non-KORHN cohort (AUC 0.890) confirmed its robustness; Conclusions: The KORHN score provides a simple, accurate tool for early neuroprognostication, supporting clinical decision-making and family communication.
Source: Journal of Clinical Medicine
DOI: 10.3390/jcm14186466
Authors: Wook Jin Choi, Jae Hoon Lee
Institutions: University of Ulsan, Dong-A University
Language: English
Subfield: Emergency Medicine
Field: Medicine
Domain: Health Sciences
Open Access status: gold
Estimated APC paid: $3,137
Funders: Catholic University of Daegu, Chonnam National University, Chung-Ang University, Dong-A University, Soonchunhyang University, Kyung Hee University, Ajou University, Ewha Womans University, Korea University, Catholic University of Korea, Korea University Anam Hospital, Samsung, Seoul St. Mary's Hospital, Catholic University of Korea
OpenAlex ID: W4414204758