PMID: 26322336Jan 1, 2014Paper

Predicting Survival with Good Neurological Outcome Within 24 Hours Following Out of Hospital Cardiac Arrest:The Application and Validation of a Novel Clinical Score

Journal of Neurology & Translational Neuroscience
Aiham AlbaeniNisha Chandra-Strobos

Abstract

Despite 50 years of research, prognostication post cardiac arrest traditionally occurs at 72 hours. We tested the accuracy of a novel bedside score within 24 hours of hospital admission, in predicting neurologically intact survival. We studied 192 adults following non-traumatic out-of-hospital cardiac arrest. In a 50% random modeling sample, a model for survival to discharge with good neurological outcome was developed using univariate analysis and stepwise multivariate logistic regression for predictor selection. The diagnostic efficiency of this modeled score was assessed in the remaining 50% sample using receiver operating characteristic (ROC) analysis. In this study, 20% of patients survived to discharge with good neurological outcome. The final logistic regression model in the modeling sample retained three predictors: initial rhythm Ventricular Fibrillation, Return of Spontaneous Circulation ≤ 20 minutes from collapse, and Brainstem Reflex Score ≥ 3 within 24 hours. These variables were used to develop a three-point Out of Hospital Cardiac Arrest score. The area under the (ROC) curve was 0.84 [95% CI, 0.75-0.93] in the modeling sample and 0.92 [95% CI, 0.87-0.98] in the validation sample. A score ≥ 2 predicted good neurol...Continue Reading

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