This external validation included 29,345 adults with presumed cardiogenic OHCA transported to tertiary care centers, predicting unfavorable neurological outcome at one month. R-EDByUS discrimination was good in prehospital ROSC and ongoing CPR cohorts, with areas under the curve of 0.906 and 0.913, respectively. Calibration was good in the prehospital ROSC cohort, but discrimination was lower among ongoing CPR patients receiving PCI, TTM, or ECMO. Among patients with predicted risk ≥99%, unfavorable outcomes occurred in 112/112 with prehospital ROSC and 20,560/20,588 with ongoing CPR.
The score showed strong overall discrimination for one-month neurological outcomes in tertiary-center OHCA patients. These findings support risk stratification, not certainty about an individual patient’s outcome.
Study limitation: Performance varied across intervention subgroups, and good calibration was reported only for the prehospital ROSC cohort.
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