Abstract
Background
The Good Outcome Following Attempted Resuscitation (GO-FAR) Score uses pre-arrest
factors to predict survival after In-Hospital Cardiac Arrest (IHCA) with minimal neurological
dysfunction, (cerebral performance category (CPC) ≤1). Moderate neurological dysfunction
(CPC ≤2) may be a more acceptable outcome.
Objective
To predict survival after IHCA with mild or moderate neurological dysfunction based
on pre-arrest factors.
Methods
52,468 patients with IHCA from 2012-2017. Data was divided into training (44%), testing
(22%), and validation (34%) sets. Univariate analysis was used to identify variables
with >3% difference in survival with CPC ≤2. These variables carried forward to the
multivariate logistic regression model. The most parsimonious model that best classified
patients as having a very poor (≤5%), below average (≤10%), average (11%–30%), or
above average (>30%) likelihood of survival with CPC ≤2 was chosen.
Results
Age >85, admission CPC <2, and non-surgical admission were strongly association with poor
survival (−12.1%, −14.4%, and −18%, respectively). Nine variables were included in
the logistic regression analysis. The final updated model, GO FAR 2, categorized 6.2%
of patients with a very poor predicted survival, 24.8% of patients with a below average
predicted survival, and 11.3% with above average predicted survival. The observed
survival among those with very poor predicted survival was 4.5%.
Conclusion
The GO FAR 2 score provides clinicians with a prognostic estimate of the likelihood
of a good outcome after IHCA based on pre-arrest patient factors. Future research
is required to validate the GO-FAR 2 score.
Keywords
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Article info
Publication history
Published online: December 07, 2019
Accepted:
December 2,
2019
Received in revised form:
November 18,
2019
Received:
August 19,
2019
Publication stage
In Press Journal Pre-ProofIdentification
Copyright
© 2019 Elsevier B.V. All rights reserved.