Simultaneous external validation of various cardiac arrest prognostic scores: a single-center retrospective study

Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine

Takumi Tsuchida¹  Kenichi Katabami¹  Kunihiko Maekawa¹  Tomonao Yoshida¹  Takeshi Wada¹  Mineji Hayakawa¹  Kota Ono² 

[1] Department of Emergency Medicine, Hokkaido University Hospital, N14W5 Kita-ku, 060-8648, Sapporo, Japan;Ono Biostat Consulting, Naritahigashi, Suginami-ku, 166-0015, Tokyo, Japan;

关键词: Out-of-hospital cardiac arrest;    Prediction;    Prognosis;    Neurological outcome;   

DOI  :  10.1186/s13049-021-00935-w

来源: Springer

【 摘 要 】

BackgroundThis study aimed to compare and validate the out-of-hospital cardiac arrest (OHCA); cardiac arrest hospital prognosis (CAHP); non-shockable rhythm, unwitnessed arrest, long no-flow or long low-flow period, blood pH < 7.2, lactate > 7.0 mmol/L, end-stage chronic kidney disease, age ≥ 85 years, still resuscitation, and extracardiac cause (NULL-PLEASE) clinical; post-cardiac arrest syndrome for therapeutic hypothermia (CAST); and revised CAST (rCAST) scores in OHCA patients treated with recent cardiopulmonary resuscitation strategies.MethodsWe retrospectively collected data on adult OHCA patients admitted to our emergency department between February 2015 and July 2018. OHCA, CAHP, NULL-PLEASE clinical, CAST, and rCAST scores were calculated based on the data collected. The predictive abilities of each score were tested using the area under the curve (AUC) of the receiver operating characteristic (ROC) curve.ResultsWe identified 236 OHCA patients from computer-based medical records and analyzed 189 without missing data. In OHCA patients without bystander witnesses, CAHP and OHCA scores were not calculated. Although the predictive abilities of the scores were not significantly different, the NULL-PLEASE score had a large AUC of ROC curve in various OHCA patients. Furthermore, in patients with bystander-witnessed OHCA, the NULL-PLEASE score had large partial AUCs of ROC from sensitivity 0.8–1.0 and specificity 0.8–1.0.ConclusionsThe NULL-PLEASE score had a high, comprehensive predictive ability in various OHCA patients. Furthermore, the NULL-PLEASE score had a high predictive ability for good and poor neurological outcomes in patients with bystander-witnessed OHCA.

【 授权许可】

CC BY