Łukasz Kołtowski1, Beata Średniawa2, Agnieszka Tycińska3, Magdalena Czajkowska4, Magdalena Niedziela5,6, Wiesław Puchalski7, Ewa Szczerba1, Robert Kowalik1, Robert Ryczek8, Barbara Zawiślak9, Elżbieta Kremis10, Konrad Koza11, Agnieszka Nazaruk12, Joanna Wolska4, Michał Ordak13, Grzegorz Opolski1, Janina Stępińska10. 1. 1st Department of Cardiology, Medical University of Warsaw, Banacha 1a, 02-097 Warsaw, Poland. 2. Department of Cardiology Medical University of Silesia SMDZ, Silesian Center for Heart Diseases, Zabrze, Poland. 3. Department of Cardiology, Medical University of Bialystok, Poland. 4. Clinical Department of Anaesthesiology and Intensive Care, Regional Specialist Hospital, University of Warmia and Mazury in Olsztyn, Poland. 5. 1st Department of Cardiology, Medical University of Warsaw, Banacha 1a, 02-097 Warsaw, Poland. magdanie@poczta.onet.pl. 6. Department of Experimental and Clinical Physiology, Centre for Preclinical Research and Technology (CePT), Medical University of Warsaw, Banacha 1b, 02-097 Warsaw, Poland. magdanie@poczta.onet.pl. 7. First Department of Cardiology, Medical University of Gdansk, Gdansk, Poland. 8. Department of Cardiology and Internal Diseases, Military Medical Institute, Warsaw, Poland. 9. 2nd Department of Cardiology and Cardiovascular Interventions, University Hospital of Krakow, Poland. 10. Intensive Cardiac Therapy Clinic, Institute of Cardiology Warsaw, Poland. 11. Department of Anaesthesiology and Intensive Care, Specialist Hospital in Siedlce, Poland. 12. Department of Invasive Cardiology, Central Clinical Hospital of Ministry of Interior and Administration, Warsaw, Poland. 13. Department of Pharmacodynamics, Centre for Preclinical Research and Technology (CePT), Medical University of Warsaw, Poland.
Abstract
BACKGROUND: Prompt reperfusion and post-resuscitation care, including targeted temperature management (TTM), improve survival in out-of-hospital cardiac arrest (OHCA) patients. To predict inhospital mortality in OHCA patients treated with TTM, the Polish Hypothermia Registry Risk Score (PHR-RS) was developed. The use of dedicated risk stratification tools may support treatment decisions. METHODS: Three hundred seventy-six OHCA patients who underwent TTM between 2012 and 2016 were retrospectively analysed and whose data were collected in the Polish Hypothermia Registry. A multivariate logistic regression model identified a set of predictors of in-hospital mortality that were used to develop a dedicated risk prediction model, which was tested for accuracy. RESULTS: The mean age of the studied population was 59.2 ± 12.9 years. 80% of patients were male, 73.8% had shockable rhythms, and mean time from cardiac arrest (CA) to cardiopulmonary resuscitation (CPR) was 7.2 ± 8.6 min. The inputs for PHR-RS were patient age and score according to the Mild Therapeutic Hypothermia (MTH) Scale. Criteria for the MTH score consisted of time from CA to CPR above 10 min, time from CA to the return of spontaneous circulation above 20 min, in-hospital CA, unwitnessed CA, and non-shockable rhythm, each counted as 1 point. The predictive value of PHR-RS was expressed as an area under the curve of 0.74. CONCLUSIONS: PHR-RS is one of the simplest and easiest models to use and enables a reliable prediction of in-hospital mortality in OHCA patients treated with TTM.
BACKGROUND: Prompt reperfusion and post-resuscitation care, including targeted temperature management (TTM), improve survival in out-of-hospital cardiac arrest (OHCA) patients. To predict inhospital mortality in OHCA patients treated with TTM, the Polish Hypothermia Registry Risk Score (PHR-RS) was developed. The use of dedicated risk stratification tools may support treatment decisions. METHODS: Three hundred seventy-six OHCA patients who underwent TTM between 2012 and 2016 were retrospectively analysed and whose data were collected in the Polish Hypothermia Registry. A multivariate logistic regression model identified a set of predictors of in-hospital mortality that were used to develop a dedicated risk prediction model, which was tested for accuracy. RESULTS: The mean age of the studied population was 59.2 ± 12.9 years. 80% of patients were male, 73.8% had shockable rhythms, and mean time from cardiac arrest (CA) to cardiopulmonary resuscitation (CPR) was 7.2 ± 8.6 min. The inputs for PHR-RS were patient age and score according to the Mild Therapeutic Hypothermia (MTH) Scale. Criteria for the MTH score consisted of time from CA to CPR above 10 min, time from CA to the return of spontaneous circulation above 20 min, in-hospital CA, unwitnessed CA, and non-shockable rhythm, each counted as 1 point. The predictive value of PHR-RS was expressed as an area under the curve of 0.74. CONCLUSIONS: PHR-RS is one of the simplest and easiest models to use and enables a reliable prediction of in-hospital mortality in OHCA patients treated with TTM.
Entities:
Keywords:
post-resuscitation care; risk prediction model; targeted temperature management; temperature control
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