{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,6]],"date-time":"2026-10-06T18:58:27Z","timestamp":1791313107464,"version":"4.3.1"},"reference-count":44,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"17","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["JAHA"],"published-print":{"date-parts":[[2025,9,2]]},"abstract":"<jats:sec xml:lang=\"en\">\n                    <jats:title>Background<\/jats:title>\n                    <jats:p xml:lang=\"en\">Selecting appropriate patients for extracorporeal cardiopulmonary resuscitation (ECPR) in cases of out\u2010of\u2010hospital cardiac arrest remains challenging, particularly for those with initial nonshockable rhythms. Our aim is to develop a prediction score to identify suitable ECPR candidates in patients with initial nonshockable rhythm.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec xml:lang=\"en\">\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p xml:lang=\"en\">The data were sourced from the SAVE\u2010J II (Study of Advanced Life Support for Ventricular Fibrillation With Extracorporeal Circulation in Japan II) study, a retrospective multicenter observational study in Japan. Included were adult patients with out\u2010of\u2010hospital cardiac arrest who underwent ECPR with initial pulseless electrical activity or asystole. The primary outcome was survival to hospital discharge. We developed a prediction score, employing logistic regression analysis and internally validating it with 1000 bootstrap samples. The performance of the score in predicting a favorable neurological outcome at discharge was also evaluated.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec xml:lang=\"en\">\n                    <jats:title>Results<\/jats:title>\n                    <jats:p xml:lang=\"en\">Among 648 eligible patients, 86 (13.3%) survived to hospital discharge. The median age was 60.5\u2009years, 75.9% (492) were male, and 74.4% (482) had pulseless electrical activity as the initial rhythm. Three clinical predictors for the START\u2010ECPR Score\u00a0(Signs of Life, Transient ROSC, Not Asystole Rhythm to ECPR Score) were identified: shockable rhythm or pulseless electrical activity at hospital arrival, transient return of spontaneous circulation before hospital arrival, and signs of life at hospital arrival. Survival rates were 4.4% (7\/159) for a score of 0, 10.7% (38\/356) for a score of 1, and 30.8% (39\/130) for scores of 2 to \u20133. The bias\u2010corrected C\u2010index for the score was 0.696. For predicting favorable neurologic outcomes at discharge, the C\u2010index was 0.761.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec xml:lang=\"en\">\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p xml:lang=\"en\">We developed a straightforward 3\u2010factor prediction score for predicting survival to hospital discharge and favorable neurologic outcomes in patients with out\u2010of\u2010hospital cardiac arrest with initial nonshockable rhythms receiving ECPR.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1161\/jaha.125.042734","type":"journal-article","created":{"date-parts":[[2025,8,29]],"date-time":"2025-08-29T11:05:04Z","timestamp":1756465504000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":7,"title":["Clinical Prediction Score for Patients With Initial Nonshockable Rhythm Receiving Extracorporeal Cardiopulmonary Resuscitation for Out\u2010of\u2010Hospital Cardiac Arrest: Development and Internal Validation"],"prefix":"10.1161","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2934-3333","authenticated-orcid":false,"given":"Akira","family":"Kawauchi","sequence":"first","affiliation":[{"name":"Japanese Red Cross Maebashi Hospital","place":["Maebashi, Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2266-476X","authenticated-orcid":false,"given":"Yohei","family":"Okada","sequence":"additional","affiliation":[{"name":"Duke\u2010NUS Medical School","place":["Singapore"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8239-8822","authenticated-orcid":false,"given":"Makoto","family":"Aoki","sequence":"additional","affiliation":[{"name":"National Defense Medical College","place":["Saitama, 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Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7562-3187","authenticated-orcid":false,"given":"Yasuhiro","family":"Kuroda","sequence":"additional","affiliation":[{"name":"Kagawa University Hospital","place":["Kita, Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0006-2084-9513","authenticated-orcid":false,"given":"Mitsunobu","family":"Nakamura","sequence":"additional","affiliation":[{"name":"Japanese Red Cross Maebashi Hospital","place":["Maebashi, Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"name":"the SAVE\u2010J II Study 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