Abstract 27: Machine Learning Models for Outcome Prediction of Out-Of-Hospital Cardiac Arrest of Presumed Cardiac Cause Using the All-Japan Utstein Registry

Abstract

Background: Outcome prediction for patients with out-of-hospital cardiac arrest (OHCA) using prehospital information has been one of the major challenges in resuscitation medicine. Recently, machine learning techniques have been shown to be highly effective in predicting outcomes using clinical registries. In this study, we aimed to establish a prediction model for outcomes of OHCA of presumed cardiac cause using machine learning techniques. Methods: We analyzed data from the All-Japan Utstein Registry of the Fire and Disaster Management Agency between 2005 and 2016. Of 1,423,338 cases, data of OHCA patients aged ≥18 years with presumed cardiac etiology were retrieved and divided into two groups: training set, n = 584,748 (between 2005 and 2013) and test set, n = 223,314 (between 2014 and 2016). The endpoints were neurologic outcome at 1-month and survival at 1-month. Of 47 variables evaluated during the prehospital course, 19 variables (e.g.,sex, age, ECG waveform, and practice of bystander CPR) were used for outcome prediction. Performances of logistic regression, random forests, and deep neural network were examined in this study. Results: For prediction of neurologic outcomes (cerebral performance category 1 or 2) using the test set, the generated models showed area under the receiver operating characteristic curve (AUROC) values of 0.942 (95% confidence interval [CI] 0.941-0.943), 0.947 (95% CI 0.946-0.948), and 0.948 (95% CI 0.948-0.950) in logistic regression, random forest, and deep neural network, respectively. For survival prediction, the generated models showed AUROC values of 0.901 (95% CI 0.900-0.902), 0.913 (95% CI 0.912-0.914), and 0.912 (95% CI 0.911-0.913) in logistic regression, random forest, and deep neural network, respectively. Conclusions: Machine learning techniques using prehospital variables showed favorable prediction capability for 1-month neurologic outcome and survival in OHCA of presumed cardiac cause.