Performance of OHCA, NULL-PLEASE and CAHP scores to predict survival in Out-of-Hospital Cardiac Arrest due to acute coronary syndrome

Pham, Vincent; Laghlam, Driss; Varenne, Olivier; Dumas, Florence; Cariou, Alain; Picard, Fabien

doi:10.1016/j.resuscitation.2021.07.011

Cited by 11 publications

(6 citation statements)

References 12 publications

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“…The severity-of-illness scores APACHE II (Acute Physiology and Chronic Health Evaluation II) and SAPS II (Simplified Acute Physiology Score II) have been widely used in critical care research, and the required clinical and laboratory parameters are readily available for all post-cardiac-arrest patients [24,25]. All four scores were successfully validated for the prediction of short-term neurological outcomes and mortality [26][27][28][29][30][31][32][33][34][35]. However, these scores have not been evaluated regarding long-term outcomes.…”

Section: Introductionmentioning

confidence: 99%

Comparison of different clinical risk scores to predict long-term survival and neurological outcome in adults after cardiac arrest: results from a prospective cohort study

Blatter

Amacher

Bohren

et al. 2022

Ann. Intensive Care

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Background Several scoring systems have been used to predict short-term outcome in patients with out-of-hospital cardiac arrest (OHCA), including the disease-specific OHCA and CAHP (Cardiac Arrest Hospital Prognosis) scores, as well as the general severity-of-illness scores Acute Physiology and Chronic Health Evaluation II (APACHE II) and Simplified Acute Physiology Score II (SAPS II). This study aimed to assess the prognostic performance of these four scores to predict long-term outcomes (≥ 2 years) in adult cardiac arrest patients. Methods This is a prospective single-centre cohort study including consecutive cardiac arrest patients admitted to intensive care in a Swiss tertiary academic medical centre. The primary endpoint was 2-year mortality. Secondary endpoints were neurological outcome at 2 years post-arrest assessed by Cerebral Performance Category with CPC 1–2 defined as good and CPC 3–5 as poor neurological outcome, and 6-year mortality. Results In 415 patients admitted to intensive care, the 2-year mortality was 58.1%, with 96.7% of survivors showing good neurological outcome. The 6-year mortality was 82.5%. All four scores showed good discriminatory performance for 2-year mortality, with areas under the receiver operating characteristics curve (AUROC) of 0.82, 0.87, 0.83 and 0.81 for the OHCA, CAHP, APACHE II and SAPS II scores. The results were similar for poor neurological outcome at 2 years and 6-year mortality. Conclusion This study suggests that two established cardiac arrest-specific scores and two severity-of-illness scores provide good prognostic value to predict long-term outcome after cardiac arrest and thus may help in early goals-of-care discussions.

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Section: Introductionmentioning

confidence: 99%

Comparison of different clinical risk scores to predict long-term survival and neurological outcome in adults after cardiac arrest: results from a prospective cohort study

Blatter

Amacher

Bohren

et al. 2022

Ann. Intensive Care

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“…Fifteen studies [ 13 , 31 , 32 , 34 , 35 , 50 – 59 ] reporting outcomes from 18 cohorts (ten prospective and eight retrospective cohorts) with a total of 4′747 patients were included in the review, of which 16 external validation cohorts [ 31 , 32 , 34 , 35 , 50 – 59 ] were available for the evaluation of the OHCA score’s prognostic performance. The studies were mainly performed in Europe ( n = 7) [ 13 , 35 , 50 , 52 , 54 , 56 , 60 ] and in Asia ( n = 6) [ 34 , 53 , 55 , 57 – 59 ] with one study each performed in the USA[ 31 ] and Australia [ 32 ], respectively. The majority of studies ( n = 11) [ 13 , 31 , 34 , 51 , 53 – 59 ] reported outcomes after OHCA, whereas three studies [ 32 , 35 , 50 ] reported outcomes of both OHCA and IHCA patients, and one study [ 52 ] reported outcomes after IHCA only.…”

Section: Resultsmentioning

confidence: 99%

“…In accordance with the original publication of the OHCA score [ 13 ], the majority of studies assessed the prognostic performance of the OHCA score for the prediction of neurological outcome ( n = 12) [ 13 , 31 , 34 , 35 , 51 – 55 , 57 – 59 ]. In contrast, three studies[ 32 , 50 , 56 ] assessed the score’s performance in predicting mortality only. The outcome assessment was performed at hospital discharge or 30 days in 15 cohorts[ 13 , 31 , 32 , 34 , 35 , 50 – 57 , 59 ] and at > 1 month in three cohorts [ 54 , 58 ] (Box 1 ).…”

Section: Resultsmentioning

confidence: 99%

“…Twenty-three out of 25 studies [ 13 , 14 , 16 , 31 , 32 , 34 , 35 , 38 , 40 – 42 , 50 – 56 , 58 , 59 , 61 , 63 , 64 ] were found to be at high risk of bias (Additional file 1 : Table S1). The high risk of bias ratings were due to issues in the “analysis” domain.…”

Section: Resultsmentioning

confidence: 99%

“…2 ). For a meta-analysis of total O:E ratios, nine studies[ 31 , 32 , 34 , 35 , 50 , 52 – 54 , 56 ] provided sufficient data. The summary total O:E ratio was 0.78 (95% CI 0.67–0.92), showing an overestimation of poor outcome by the OHCA score (Fig.…”

Section: Resultsmentioning

confidence: 99%

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Predicting neurological outcome in adult patients with cardiac arrest: systematic review and meta-analysis of prediction model performance

et al. 2022

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This work aims to assess the performance of two post-arrest (out-of-hospital cardiac arrest, OHCA, and cardiac arrest hospital prognosis, CAHP) and one pre-arrest (good outcome following attempted resuscitation, GO-FAR) prediction model for the prognostication of neurological outcome after cardiac arrest in a systematic review and meta-analysis. A systematic search was conducted in Embase, Medline, and Web of Science Core Collection from November 2006 to December 2021, and by forward citation tracking of key score publications. The search identified 1′021 records, of which 25 studies with a total of 124′168 patients were included in the review. A random-effects meta-analysis of C-statistics and overall calibration (total observed vs. expected [O:E] ratio) was conducted. Discriminatory performance was good for the OHCA (summary C-statistic: 0.83 [95% CI 0.81–0.85], 16 cohorts) and CAHP score (summary C-statistic: 0.84 [95% CI 0.82–0.87], 14 cohorts) and acceptable for the GO-FAR score (summary C-statistic: 0.78 [95% CI 0.72–0.84], five cohorts). Overall calibration was good for the OHCA (total O:E ratio: 0.78 [95% CI 0.67–0.92], nine cohorts) and the CAHP score (total O:E ratio: 0.78 [95% CI 0.72–0.84], nine cohorts) with an overestimation of poor outcome. Overall calibration of the GO-FAR score was poor with an underestimation of good outcome (total O:E ratio: 1.62 [95% CI 1.28–2.04], five cohorts). Two post-arrest scores showed good prognostic accuracy for predicting neurological outcome after cardiac arrest and may support early discussions about goals-of-care and therapeutic planning on the intensive care unit. A pre-arrest score showed acceptable prognostic accuracy and may support code status discussions. Graphical Abstract

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Prognosis of out-of-hospital cardiac arrest due to acute myocardial infarction with or without ST-segment elevation in patients treated with percutaneous coronary intervention

Pham¹,

Varenne²,

Cariou³

et al. 2023

Archives of Cardiovascular Diseases

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Performance of OHCA, NULL-PLEASE and CAHP scores to predict survival in Out-of-Hospital Cardiac Arrest due to acute coronary syndrome

Cited by 11 publications

References 12 publications

Comparison of different clinical risk scores to predict long-term survival and neurological outcome in adults after cardiac arrest: results from a prospective cohort study

Comparison of different clinical risk scores to predict long-term survival and neurological outcome in adults after cardiac arrest: results from a prospective cohort study

Predicting neurological outcome in adult patients with cardiac arrest: systematic review and meta-analysis of prediction model performance

Prognosis of out-of-hospital cardiac arrest due to acute myocardial infarction with or without ST-segment elevation in patients treated with percutaneous coronary intervention

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