Table 1.
Estimated Prognostic Test Performance and Prognostic Association for Sonographic Findings on Point-of-Care Echocardiography During Cardiac Arrest to Predict Clinical Outcomes.
| Outcome | Author, Year | Total Subjects (n), IHCA or OHCA | Sensitivity (Range or 95% CI) | Specificity (Range or 95% CI) | Odds Ratio (Range or 95% CI) |
|---|---|---|---|---|---|
| Organized Cardiac Motion (Unspecified Timing of Echocardiography) | |||||
| Survival 180 days | Flato, 2015113 | 49, IHCA | 1.0 (95% CI, 0.4–1.0) | 0.49 (95% CI, 0.34–0.64) | 8.62 (95% CI, 0.44–169.38) |
| Survival to hospital discharge | Atkinson, 2019108 Flato, 2015113 |
229, IHCA and OHCA | 0.67–1.00 | 0.51–0.89 | 13.60–16.63 |
| Survival to hospital admission | Atkinson, 2019108 Blaivas, 2001109 |
349, OHCA | 0.39–1.00 | 0.91–0.91 | 6.73–414.56 |
| ROSC | Atkinson, 2019108 Flato, 2015113 |
229, IHCA and OHCA | 0.34–0.79 | 0.68–0.96 | 8.07–13.21 |
| Nonorganized and/or Unspecified Cardiac Motion on Initial Echocardiogram | |||||
| Good neurological outcome at discharge | Aichinger, 2012107 | 42, OHCA | 1.00 (95% CI, 0.03–1.00) | 0.78 (95% CI, 0.62–0.89) | 10.26 (95% CI, 0.39–273.09) |
| Survival to hospital discharge | Gaspari, 2016114 Varriale, 1997106 Zengin, 2016116 |
1171, † IHCA and OHCA | 0.06–0.91 | 0.49–0.94 | 0.38–17.00 |
| Survival to hospital admission | Aichinger, 2012107 Gaspari, 2016114 Salen, 2001104 Zengin, 2016116 |
1295,† IHCA and OHCA | 0.11–0.92 | 0.55–0.85 | 0.75–27.56 |
| ROSC | Gaspari, 2016114 Kim, 2016115 Varriale, 1997106 |
861, IHCA and OHCA | 0.25–0.64 | 0.78–1.00 | 6.33–16.11 |
| Nonorganized and/or Unspecified Cardiac Motion on Every Echocardiogram | |||||
| Survival to hospital admission | Aichinger, 2012107 Salen, 2001104 |
134,* OHCA | 0.50–0.80 | 0.92–1.00 | 45.33–148.20 |
| Nonorganized and/or Unspecified Cardiac Motion (Unspecified Timing of Echocardiography) | |||||
| Good neurological outcome at 180 days | Flato, 2015113 | 49, IHCA | 1.00 (95% CI, 0.40–1.00) | 0.49 (95% CI, 0.34–0.64) | 8.62 (95% CI, 0.44–169.38) |
| Good neurological outcome at discharge | Salen, 2005103 | 70, OHCA | 1.00 (95% CI, 0.03–1.00) | 0.86 (95% CI, 0.75–0.93) | 17.00 (95% CI, 0.65–446.02) |
| Survival to hospital discharge | Lien, 2018102 | 177, OHCA | 0.48 (95% CI, 0.28–0.69) | 0.77 (95% CI, 0.69–0.83) | 3.09 (95% CI, 1.29–7.37) |
| Survival to hospital admission | Breitkreutz, 2010110 Chua, 2017112 Salen, 2001104 |
291,* OHCA | 0.72–0.86 | 0.60–0.84 | 9.14–14.00 |
| ROSC | Chardoli, 2012111 Lien, 2018102 Salen, 2005103 Tayal, 2003105 |
317, OHCA | 0.62–1.00 | 0.33–0.98 | 23.18–289.00 |
| Return of Organized Cardiac Motion on Subsequent Echocardiogram | |||||
| Survival to hospital discharge | Varriale, 1997106 | 20, IHCA | 0.50 (95% CI, 0.01–0.99) | 0.79 (95% CI, 0.54–0.94) | 3.75 (95% CI, 0.19–74.06) |
| ROSC | Varriale, 1997106 | 20, IHCA | 0.67 (95% CI, 0.22–0.96) | 1.00 (95% CI, 0.77–1.00) | 52.50 (95% CI, 2.10–1300.33) |
| Coalescent Echo Contrast (ie, Visible Clotted Intra-Cardiac Blood) After 20–30 min of CPR | |||||
| Survival to hospital discharge | Varriale, 1997106 | 20, IHCA | 0.00 (95% CI, 0.00–0.84) | 0.45 (95% CI, 0.23–0.68) | 0.13 (95% CI, 0.01–3.11) |
| ROSC | Varriale, 1997106 | 20, IHCA | 0.00 (95% CI, 0.00–0.46) | 0.21 (95% CI, 0.05–0.51) | 0.02 (95% CI, 0.00–0.53) |
| Sonographic Evidence of Treatable Pathology | |||||
| Survival to hospital discharge | Gaspari, 2016114 Varriale, 1997106 Zengin, 2016116 |
1130,† IHCA and OHCA | 0.00–0.15 | 0.89–0.98 | 1.32–4.25 |
| Survival to hospital admission | Zengin, 2016116 | 531,† IHCA and OHCA | 0.03–0.04 | 0.95–0.99 | 0.61–4.70 |
| ROSC | Chardoli, 2012111 Lien, 2018102 Tayal, 2003105 Varriale, 1997106 |
317,† IHCA and OHCA | 0.00–1.00 | 0.84–0.94 | 0.38–125.00 |
IHCA indicates in-hospital cardiac arrest; OHCA, out-of-hospital cardiac arrest; and ROSC, return of spontaneous circulation.
*
Studies did not report these data for all enrolled subjects; n is lower than the total of all subjects enrolled.
†
Gaspari et al and Zengin et al report multiple sonographic findings within a given category on the same subjects; n reflects composite variable “subject-assessments”.