Carole Maupain1,2, Wulfran Bougouin1,2,3, Lionel Lamhaut1,2,4, Nicolas Deye1,5, Jean-Luc Diehl2,6, Guillaume Geri1,2,3, Marie-Cécile Perier1, Frankie Beganton1, Eloi Marijon1,2,7, Xavier Jouven1,2,7, Alain Cariou1,2,3, Florence Dumas8,2,9. 1. Paris Sudden Death Expertise Center, INSERM U970 (PARCC), Paris, France. 2. Paris Descartes-Sorbonne Cité University, Paris, France. 3. Intensive Care Unit, Cochin Hospital, AP-HP, Paris, France. 4. Department of Anesthesiology and Emergency Medical Services-SAMU 75-, Necker Hospital, AP-HP, Paris, France. 5. Intensive Care Unit, Lariboisière University Hospital, AP-HP, Paris, France. 6. Medical Intensive Care Unit, Georges Pompidou European Hospital, AP-HP, Paris, France. 7. Cardiology Department, Georges Pompidou European Hospital, AP-HP, Paris, France. 8. Paris Sudden Death Expertise Center, INSERM U970 (PARCC), Paris, France florence.dumas@cch.aphp.fr. 9. Emergency Department, Cochin-Hotel-Dieu Hospital, APHP, Paris, France.
Abstract
AIMS: Survival after out-of-hospital cardiac arrest (OHCA) remains disappointingly low. Among patients admitted alive, early prognostication remains challenging. This study aims to establish a stratification score for patients admitted in intensive care unit (ICU) after OHCA, according to their neurological outcome. METHODS AND RESULTS: The CAHP (Cardiac Arrest Hospital Prognosis) score was developed from the Sudden Death Expertise Center registry (Paris, France). The primary outcome was poor neurological outcome defined as Cerebral Performance Category 3, 4, or 5 at hospital discharge. Independent prognostic factors were identified using logistic regression analysis and thresholds defined to stratify low-, moderate-, and high-risk groups. The CAHP score was validated in both a prospective and an external data set (Parisian Cardiac Arrest Registry). The developmental data set included 819 patients admitted from May 2011 to December 2012. After multivariate analysis, seven variables were independently associated with poor neurological outcome and subsequently included in the CAHP score (age, non-shockable rhythm, time from collapse to basic life support, time from basic life support to return of spontaneous circulation, location of cardiac arrest, epinephrine dose, and arterial pH). Three risks groups were identified: low risk (score ≤150, 39% of unfavourable outcome), medium risk (score 150-200, 81% of unfavourable outcome) and high-risk group (score ≥200, 100% of unfavourable outcome). The AUC of the CAHP score were 0.93, and the discrimination value in the validation data sets was consistent (respectively, AUC 0.91 and 0.85). CONCLUSION: The CAHP score represents a simple tool for early stratification of patients admitted in ICU after OHCA. A high-risk category of patients with very poor prognosis can be easily identified. Published on behalf of the European Society of Cardiology. All rights reserved.
AIMS: Survival after out-of-hospital cardiac arrest (OHCA) remains disappointingly low. Among patients admitted alive, early prognostication remains challenging. This study aims to establish a stratification score for patients admitted in intensive care unit (ICU) after OHCA, according to their neurological outcome. METHODS AND RESULTS: The CAHP (Cardiac Arrest Hospital Prognosis) score was developed from the Sudden Death Expertise Center registry (Paris, France). The primary outcome was poor neurological outcome defined as Cerebral Performance Category 3, 4, or 5 at hospital discharge. Independent prognostic factors were identified using logistic regression analysis and thresholds defined to stratify low-, moderate-, and high-risk groups. The CAHP score was validated in both a prospective and an external data set (Parisian Cardiac Arrest Registry). The developmental data set included 819 patients admitted from May 2011 to December 2012. After multivariate analysis, seven variables were independently associated with poor neurological outcome and subsequently included in the CAHP score (age, non-shockable rhythm, time from collapse to basic life support, time from basic life support to return of spontaneous circulation, location of cardiac arrest, epinephrine dose, and arterial pH). Three risks groups were identified: low risk (score ≤150, 39% of unfavourable outcome), medium risk (score 150-200, 81% of unfavourable outcome) and high-risk group (score ≥200, 100% of unfavourable outcome). The AUC of the CAHP score were 0.93, and the discrimination value in the validation data sets was consistent (respectively, AUC 0.91 and 0.85). CONCLUSION: The CAHP score represents a simple tool for early stratification of patients admitted in ICU after OHCA. A high-risk category of patients with very poor prognosis can be easily identified. Published on behalf of the European Society of Cardiology. All rights reserved.
Authors: Jonathan Elmer; Bobby L Jones; Vladimir I Zadorozhny; Juan Carlos Puyana; Kate L Flickinger; Clifton W Callaway; Daniel Nagin Journal: Resuscitation Date: 2019-02-27 Impact factor: 5.262
Authors: Chen Ji; Terry P Brown; Scott J Booth; Claire Hawkes; Jerry P Nolan; James Mapstone; Rachael T Fothergill; Robert Spaight; Sarah Black; Gavin D Perkins Journal: Eur Heart J Qual Care Clin Outcomes Date: 2021-03-15
Authors: Weiting Huang; Gary Kuan Wee Teo; Jack Wei-Chieh Tan; Nur Shahidah Ahmad; Hwee Hong Koh; Marcus Eng Hock Ong Journal: Heart Asia Date: 2018-06-15
Authors: Tom P Aufderheide; Rajat Kalra; Marinos Kosmopoulos; Jason A Bartos; Demetris Yannopoulos Journal: Ann N Y Acad Sci Date: 2021-02-20 Impact factor: 5.691
Authors: Purav Mody; Ambarish Pandey; Arthur S Slutsky; Matthew W Segar; Alex Kiss; Paul Dorian; Janet Parsons; Damon C Scales; Valeria E Rac; Sheldon Cheskes; Arlene S Bierman; Beth L Abramson; Sara Gray; Rob A Fowler; Katie N Dainty; Ahamed H Idris; Laurie Morrison Journal: Circulation Date: 2020-12-15 Impact factor: 29.690
Authors: Christoph Schriefl; Christian Schoergenhofer; Michael Poppe; Christian Clodi; Matthias Mueller; Florian Ettl; Bernd Jilma; Juergen Grafeneder; Michael Schwameis; Heidrun Losert; Michael Holzer; Fritz Sterz; Andrea Zeiner-Schatzl Journal: Sci Rep Date: 2021-05-13 Impact factor: 4.379