Death Foretold: Are We Truly Improving Outcome Prediction After Cardiac Arrest or Nurturing Self-Fulfilling Prophecies?

The article discusses outcome prediction after cardiac arrest and the potential for self-fulfilling prophecies in medical care. It presents guidelines for neuroprognostication in unconscious cardiac arrest survivors and the findings of a retrospective study that reassessed the entry point for the algorithm. The study found a false-positive rate of 0% when applied to different patient populations but raises concerns about self-fulfilling prophecies and the need for further research. Another study found that over one-third of patients were alive and independent at the 6-month follow-up, indicating that therapeutic nihilism is misguided. The authors suggest implementing guideline-concordant neuroprognostication timed no earlier than 72 hours postarrest. [Extracted from the article]