OBJECTIVE: The aim of this study in out-of-hospital cardiac arrest (OHCA) 
patients treated with targeted temperature management (TTM) was to evaluate the 
prognostic value of OHCA, C-GRApH, and CAHP scores with initial neurologic 
examinations for predicting neurologic outcomes.
METHODS: This retrospective study included OHCA patients treated with TTM from 
2009 to 2017. We calculated three cardiac arrest (CA)-specific risk scores 
(OHCA, C-GRApH, and CAHP) at the time of admission. The initial neurologic 
examination included an evaluation of the Full Outline of UnResponsiveness 
brainstem reflexes (FOUR_B) and Glasgow Coma Scale motor (GCS_M) scores. The 
primary outcome was the neurologic outcome at hospital discharge.
RESULTS: Of 311 subjects, 99 (31.8%) had a good neurologic outcome at hospital 
discharge. The OHCA score had an area under the receiver operating 
characteristic curve (AUROC) of 0.844 (95% confidence interval (CI): 
0.798-0.884), the C-GRApH score had an AUROC of 0.779 (95% CI: 0.728-0.824), and 
the CAHP score had an AUROC of 0.872 (95% CI: 0.830-0.907). The addition of the 
FOUR_B or GCS_M score to the OHCA score improved the prediction of poor 
neurologic outcome (with FOUR_B: AUROC = 0.899, p = 0.001; with GCS_M: AUROC = 
0.880, p = 0.004). The results were similar with the C-GRApH and CAHP scores in 
predicting poor neurologic outcome.
CONCLUSIONS: This study confirms the good prognostic performance of CA-specific 
scores to predict neurologic outcomes in OHCA patients treated with TTM. By 
adding new variables associated with the initial neurologic examinations, the 
prognoses of neurologic outcomes improved compared to the existing scoring 
models.