The specificity of the ERC-ESICM-recommended EEG patterns for predicting poor outcome after cardiac arrest exceeds 90% but is lower than in previous studies, suggesting that large-scale implementation may reduce their accuracy.

Combining HMEP with an unreactive EEG background significantly improved specificity. As in other prognostication studies, a self-fulfilling prophecy bias may have contributed to observed results.

845 patients at 59 sites were included. Of these, 579 (69%) had poor outcome, including 304 (36%) with WLST due to poor neurological prognosis.

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