The aim of this study was to develop a score to predict the outcome for patients brought to hospital following out-of-hospital cardiac arrest (OHCA).
All patients recorded in the German Resuscitation Registry (GRR) who suffered OHCA 2010–2017, who had ROSC or ongoing CPR at hospital admission were included. The study population was divided into development (2010–2016: 7985) and validation dataset (2017: 1806). Binary logistic regression analysis was used to derive the score. The probability of hospital discharge with good neurological outcome was defined as 1/(1 + e−X), where X is the weighted sum of independent variables.
The following variables were found to have a significant positive (+) or negative (−) impact: age 61–70 years (−0·5), 71–80 (−0·9), 81–90 (−1·3) and > = 91 (−2·3); initial PEA (−0·9) and asystole (−1·4); presumable trauma (−1·1); mechanical CPR (−0·3); application of adrenalin > 0 − < 2 mg (−1·1), 2 − <4 mg (−1·6), 4 − < 6 mg (−2·1), 6 − < 8 mg (−2·5) and > = 8 mg (−2·8); pre emergency status without previous disease (+0·5) or minor disease (+0·2); location at nursing home (−0·6), working place/school (+0·7), doctor’s office (+0·7) and public place (+0·3); application of amiodarone (+0·4); hospital admission with ongoing CPR (−1·9) or normotension (+0·4); witnessed arrest (+0·6); time from collapse until start CPR 2 − < 10 min (−0·3) and > = 10 min (−0·5); duration of CPR <5 min (+0·6). The AUC in the development dataset was 0·88 (95% CI 0·87–0·89) and in the validation dataset 0·88 (95% CI 0·86–0·90).
The CaRdiac Arrest Survival Score (CRASS) represents a tool for calculating the probability of survival with good neurological function for patients brought to hospital following OHCA.
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- ROSC after cardiac arrest — the RACA score to predict outcome after out-of-hospital cardiac arrest.Eur Heart J. 2011; 32: 1649-1656
- Predicting survival with good neurological recovery at hospital admission after successful resuscitation of out-of-hospital cardiac arrest: the OHCA score.Eur Heart J. 2006; 27: 2840-2845
- The CAHP (Cardiac Arrest Hospital Prognosis) score: a tool for risk stratification after out-of-hospital cardiac arrest.Eur Heart J. 2016; 37: 3222-3228
- EuReCa ONE-27 Nations, ONE Europe, ONE Registry: a prospective one month analysis of out-of-hospital cardiac arrest outcomes in 27 countries in Europe.Resuscitation. 2016; 105: 188-195
- A national resuscitation registry of out-of-hospital cardiac arrest in Germany-a pilot study.Resuscitation. 2009; 80: 199-203
- German resuscitation registry — structured resuscitation data collection: pre-hospital care and in-hospital care.Anästh Intensivmed. 2011; 52: S707-15
- Cardiac arrest and cardiopulmonary resuscitation outcome reports: update of the utstein resuscitation registry templates for out-of-hospital cardiac arrest: a statement for healthcare professionals from a task force of the International Liaison Committee on Resuscitation (American Heart Association, European Resuscitation Council, Australian and New Zealand Council on Resuscitation, Heart and Stroke Foundation of Canada, InterAmerican Heart Foundation, Resuscitation Council of Southern Africa, Resuscitation Council of Asia); and the American Heart Association Emergency Cardiovascular Care Committee and the Council on Cardiopulmonary, Critical Care, Perioperative and Resuscitation.Resuscitation. 2015; 96: 328-340
- Update of the trauma risk adjustment model of the TraumaRegister DGU: the revised injury severity classification, version II.Crit Care. 2014; 18: 476
- A review of goodness of fit statistics for use in the development of logistic regression models.Am J Epidemiol. 1982; 115: 92-106
- Qualitätsindikatoren und strukturelle Voraussetzungen für Cardiac-Arrest-Zentren — Deutscher Rat für Wiederbelebung/German Resuscitation Council (GRC).Notfall Rettungsmed. 2017; 20: 234-236
- European resuscitation council and european society of intensive care medicine guidelines for post-resuscitation care 2015: section 5 of the European resuscitation council guidelines for resuscitation 2015.Resuscitation. 2015; 95: 202-222
- Chest compression quality management and return of spontaneous circulation: a matched-pair registry study.Resuscitation. 2012; 83: 1212-1218
- External validation of the ROSC after cardiac arrest (RACA) score in a physician staffed emergency medical service system.Scand J Trauma Resusc Emerg Med. 2017; 25: 34
- The impact of response time reliability on CPR incidence and resuscitation success — a benchmark study from the German resuscitation registry.Crit Care. 2011; 15: R282
- Early predictors of poor outcome after out-of-hospital cardiac arrest.Critical Care. 2017; 21: 96
- Survival and outcome prediction using the Apache III and the out-of-hospital cardiac arrest (OHCA) score in patients treated in the intensive care unit (ICU) following out-of-hospital, in-hospital or ICU cardiac arrest.Resuscitation. 2012; 83: 728-733
- Serial evaluation of SOFA and APACHE II scores to predict neurologic outcomes of out-of-hospital cardiac arrest survivors with targeted temperature management.PLoS One. 2018; 13e0195628
- Combination of initial neurologic examination, quantitative brain imaging and electroencephalography to predict outcome after cardiac arrest.Resuscitation. 2017; 110: 120-125
- Predicting the outcomes for out-of-hospital cardiac arrest patients using multiple biomarkers and suspension microarray assays.Sci Rep. 2016; 6: 27187
Published online: November 12, 2019
Accepted: October 29, 2019
Received in revised form: October 29, 2019
Received: June 9, 2019
© 2019 Elsevier B.V. All rights reserved.