Clinical and electrophysiologic associations with outcome in initially comatose survivors of cardiac arrest
Bibliographic record
Abstract
Prognostic assessment of the comatose survivor of cardiac arrest with intact brain stem reflexes is still problematic and requires further study to determine those factors correlate with an outcome no better than vegetative state (VS). Comatose survivors of cardiac arrest with GCS ≤ 8 on day 1 before sedation; first EEG and SSEP between 24 and 36 hours from cardiac arrest; survival for at least 4 days. Patients with brain death, sedation immediately after resuscitation, additional cause for coma, preceding peripheral neuropathy or cervical myelopathy. Standardized EEG classification system and SSEPs were applied. Followup at 3 months with phone call to determine the Glasgow Outcome Scale score (GOS) and whether or not awareness had been recovered. Forty-six men and 29 women with mean age of 74 (range 21–84) years. Fifty-seven (76%) of the arrests were out-of-hospital and were due to primary cardiac causes in 70 (93%). Significant differences in clinical features between those who died and those who survived were oculovestibular and pharyngeal reflexes (no survivors in those who lost these) and motor response. There were no survivors with better than VS in those with generalized epileptiform discharges or suppression of < 20 μV on EEG and absent N20 on SSEPs. EEG and EP responses correlating with recovery of awareness included those with intermittent EEG slowing and those with preserved N70 responses. In this preliminary study, the only variables that were consistently associated with an outcome no better than VS were: absence of oculovestibular and pharyngeal reflexes, generalized epileptiform discharges or suppression of < 20 μV on EEG and absent N20 on SSEPs.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.002 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".