Predicting neurologically intact survival after in-hospital cardiac arrest-external validation of the Good Outcome Following Attempted Resuscitation score.

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Predicting neurologically intact survival after in-hospital cardiac arrest-external validation of the Good Outcome Following Attempted Resuscitation score.

Piscator, Eva (author): Karolinska Institutet,Center for Resuscitation Science, Department of Medicine Solna, Karolinska Institutet and Function of Emergency Medicine Karolinska University Hospital

Göransson, Katarina, 1974- (author): Karolinska Institutet,Department of Medicine Solna, Karolinska Institutet and Function of Emergency Medicine Karolinska University Hospital,Karolinska Institutet, Stockholm, Sweden

Bruchfeld, Samuel (author): Function of Emergency Medicine Karolinska University Hospital

Hammar, Ulf (author): Institute of Environmental Medicine (IMM), Biostatistics, Karolinska Institutet

El Gharbi, Sara (author): Function of Emergency Medicine Karolinska University Hospital

Ebell, Mark (author): Department of Epidemiology and Biostatistics, College of Public Health, University of Georgia

Herlitz, Johan, 1949- (author): Högskolan i Borås,Akademin för vård, arbetsliv och välfärd

Djärv, Therese (author): Karolinska Institutet,Center for Resuscitation Science, Department of Medicine Solna, Karolinska Institutet and Function of Emergency Medicine Karolinska University Hospital

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Elsevier BV, 2018
2018
English.
In: Resuscitation. - : Elsevier BV. - 0300-9572 .- 1873-1570. ; 128, s. 63-69

Related links:: https://urn.kb.se/re...; show more...; https://doi.org/10.1...; http://kipublication...; https://urn.kb.se/re...; show less...

Journal article (peer-reviewed)

Abstract Subject headings

BACKGROUND: A do-not-attempt-resuscitation order is issued when it is against the wishes of the patient that cardiopulmonary resuscitation is performed, or when the chance of good quality survival is minimal. Therefore it is essential for physicians to make an objective prearrest prediction of the outcome after an in-hospital cardiac arrest (IHCA). Our aim was external validation of the Good Outcome Following Attempted Resuscitation (GO-FAR) score in a population based setting.METHODS: The study was based on a retrospective cohort of adult IHCAs in Stockholm County 2013-2014 identified through the Swedish Cardiopulmonary Resuscitation Registry. This registry provided patient and event characteristics and neurological outcome at discharge. Neurologically intact survival is defined as Cerebral Performance Category score (CPC) 1 at discharge. Data for the GO-FAR variables was obtained from manual review of electronic patient records. Model performance was evaluated by measure of discrimination with the area under the receiver operating curve (AUROC) and calibration with assessment of the calibration plot.RESULTS: The cohort included 717 patients with neurologically intact survival at discharge of 22%. In complete case analysis (523 cases) AUROC was 0.82 (95% CI 0.78-0.86) indicating good discrimination. The calibration plot showed that the GO-FAR score systematically underestimates the probability of neurologically intact survival.CONCLUSION: The GO-FAR score has satisfactory discrimination, but assessment of the calibration shows that neurologically intact survival is systematically underestimated. Therefore, only with caution should it without model update be taken into clinical practice in settings similar to ours.

Subject headings

MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Anestesi och intensivvård (hsv//swe)
MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Anesthesiology and Intensive Care (hsv//eng)
MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Kardiologi (hsv//swe)
MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Cardiac and Cardiovascular Systems (hsv//eng)

Keyword

Cardiopulmonary resuscitation
Clinical decision-making
Heart arrest
In-hospital cardiac arrest
Medical futility
Prognosis
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Människan i vården

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By the author/editor: Piscator, Eva; Göransson, Katar ...; Bruchfeld, Samue ...; Hammar, Ulf; El Gharbi, Sara; Ebell, Mark; show more...; Herlitz, Johan, ...; Djärv, Therese; show less...

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MEDICAL AND HEALTH SCIENCES: MEDICAL AND HEAL ...; and Clinical Medicin ...; and Anesthesiology a ...

MEDICAL AND HEALTH SCIENCES: MEDICAL AND HEAL ...; and Clinical Medicin ...; and Cardiac and Card ...

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By the university: University of Borås; Karolinska Institutet; Högskolan Dalarna

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