Abstract
Aim
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).
Methods
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.
Results
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).
Conclusion
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.
Keywords
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Article info
Publication history
Published online: November 12, 2019
Accepted:
October 29,
2019
Received in revised form:
October 29,
2019
Received:
June 9,
2019
Identification
Copyright
© 2019 Elsevier B.V. All rights reserved.
