scholarly journals Cardiac arrest survival post-resuscitation in-hospital (CASPRI)—a tool to predict neurological outcome after ROSC

2020 ◽  
Author(s):  
Bofu Liu ◽  
Yarong He ◽  
Peng Jiang ◽  
Jiachen Sun ◽  
Tianyong Han ◽  
...  
Keyword(s):  
Risk Factors ◽  
Emergency Department ◽  
Cardiac Arrest ◽  
Roc Curve ◽  
Sofa Score ◽  
Test Group ◽  
Neurological Function ◽  
Neurological Prognosis ◽  
The Difference ◽  
Cardiac Arrest Survival

Abstract Objectives: To develop a cardiac arrest survival post-resuscitation in-hospital (CASPRI) scoring system evaluating the prognosis of neurological function in ROSC patients.Methods: This single-center, retrospective study reviewed the eligible patients admitted to the emergency department of West China Hospital of Sichuan University who received cardiopulmonary resuscitation and restored spontaneous circulation from January 1, 2014 00:00 to December 31, 2017 23:59. Clinical histories, blood test, biochemistry profile, coagulation indexes and other laboratory tests during emergency department visit were collected. The MEWS, sOHCA, APACHE II, and the highest SOFA scores were calculated during the period between emergency room admission and ROSC. The clinical data of ROSC patients in the test group were analyzed by univariate and multivariate logistic analysis. The possible risk factors related to the unfavorable prognosis of 90-day neurological function were screened and CASPRI score was constructed. The efficacy of CASPRI score on evaluating the neurological function of ROSC patients was analyzed by ROC curve and proved in the validation group.Main results: 503 patients were included in the test group. After correcting potential confounding factors, multivariate logistic regression analysis showed that TBIL, ALB at admission of emergency department, Lac at ROSC, resuscitation time, non-shockable rhythms were independent risk factors for poor neurological prognosis of ROSC patients (p<0.05). ROC curve showed that the CASPRI score was superior to the APACHE II score, SOFA score, MEWS score and sOHCA score, and the difference was statistically significant (p<0.05). In the validation group with 256 patients included, the incidence of poor neurological prognosis in high-risk, intermediate-risk, and low-risk groups based on CASPRI score were 97.89%, 85.59%, and 58.33%, respectively, and the difference was statistically significant (p<0.001). CASPRI score was superior to the SOFA score and MEWS score, the difference was statistically significant (p<0.05).Conclusions: CASPRI score is an effective tool for the early evaluation of the neurological prognosis of ROSC patients. Its efficacy exceeds the MEWS and SOFA scoring systems currently used in clinical practice.

scholarly journals Independent Risk Factors for Sepsis-Associated Cardiac Arrest in Patients with Septic Shock

2021 ◽  
Vol 18 (9) ◽  
pp. 4971
Author(s):  
Won Soek Yang ◽  
Youn-Jung Kim ◽  
Seung Mok Ryoo ◽  
Won Young Kim
Keyword(s):  
Risk Factors ◽  
Emergency Department ◽  
Septic Shock ◽  
Cardiac Arrest ◽  
Serum Lactate ◽  
Adult Age ◽  
Reactive Protein ◽  
Infection Source ◽  
Observational Cohort ◽  
Independent Risk Factors

The clinical characteristics and laboratory values of patients with septic shock who experience in-hospital cardiac arrest (IHCA) have not been well studied. This study aimed to evaluate the prevalence of IHCA after admission into the emergency department and to identify the factors that increase the risk of IHCA in septic shock patients. This observational cohort study used a prospective registry of septic shock patients and was conducted at the emergency department of a university-affiliated hospital. The data of 887 adult (age ≥ 18 years) septic shock (defined using the Sepsis-3 criteria) patients who were treated with a protocol-driven resuscitation bundle therapy and were admitted to the intensive care unit between January 2010 and September 2018 were analyzed. The primary endpoint was the occurrence of sepsis-associated cardiac arrest. The patient mean age was 65 years, and 61.8% were men. Sepsis-associated cardiac arrest occurred in 25.3% of patients (n = 224). The 28-day survival rate after cardiac arrest was 6.7%. Multivariate logistic regression identified chronic pulmonary disease (odds ratio (OR) 2.06), hypertension (OR 0.48), unknown infection source (OR 1.82), a hepatobiliary infection source (OR 0.25), C-reactive protein (OR 1.03), and serum lactate level 6 h from shock (OR 1.34). Considering the high mortality rate of sepsis-associated cardiac arrest after cardiopulmonary resuscitation, appropriate monitoring is required in septic shock patients with major risk factors for IHCA.

scholarly journals Cardiac Arrest Survival Post-Electrocution – Management in a Low-Resource Emergency Department in Ghana

2017 ◽  
Vol 32 (S1) ◽  
pp. S189
Author(s):  
Nkechi O. Dike ◽  
Nana Serwaa A. Quao ◽  
Charles Ababio ◽  
Davidson Iroko ◽  
George Oduro
Keyword(s):  
Emergency Department ◽  
Cardiac Arrest ◽  
Low Resource ◽  
Cardiac Arrest Survival

scholarly journals Evaluation of prognostic prediction models for out-of-hospital cardiac arrest

2020 ◽  
pp. 102490792096691
Author(s):  
Yat Hei Lo ◽  
Yuet Chung Axel Siu
Keyword(s):  
Emergency Department ◽  
Cardiac Arrest ◽  
Prediction Models ◽  
Model Development ◽  
Spontaneous Circulation ◽  
Emergency Team ◽  
Survival Score ◽  
Prognostic Prediction ◽  
Cardiac Arrest Survival ◽  
Hospital Cardiac Arrest

Introduction: Accurate prognostic prediction of out-of-hospital cardiac arrest is challenging but important for the emergency team and patient’s family members. A number of prognostic prediction models specifically designed for out-of-hospital cardiac arrest are developed and validated worldwide. Objective: This narrative review provides an overview of the prognostic prediction models out-of-hospital cardiac arrest patients for use in the emergency department. Discussion: Out-of-hospital cardiac arrest prognostic prediction models are potentially useful in clinical, administrative and research settings. Development and validation of such models require prehospital and hospital predictor and outcome variables which are best in the standardised Utstein Style. Logistic regression analysis is traditionally employed for model development but machine learning is emerging as the new tool. Examples of such models available for use in the emergency department include ROSC After Cardiac Arrest, CaRdiac Arrest Survival Score, Utstein-Based Return of Spontaneous Circulation, Out-of-Hospital Cardiac Arrest, Cardiac Arrest Hospital Prognosis and Cardiac Arrest Survival Score. The usefulness of these models awaits future studies.

scholarly journals The Prognostic Value of the SOFA Score in Patients with COVID-19: A Retrospective, Observational Study

2020 ◽  
Author(s):  
Zheng Yang ◽  
Qinming Hu ◽  
Fei Huang ◽  
Shouxin Xiong ◽  
Yi Sun
Keyword(s):  
Risk Factors ◽  
Organ Failure ◽  
Roc Curve ◽  
Sofa Score ◽  
Proportional Hazards Model ◽  
Cox Proportional Hazards Model ◽  
Rank Test ◽  
Hospital Death ◽  
Cutoff Value ◽  
Risk Of Death

Abstract Background: Patients with Coronavirus disease 2019 (COVID-19) have a high mortality rate, and thus, it is particularly important to predict the severity and prognosis of COVID-19. The Sequential Organ Failure Assessment (SOFA) score has been used to predict the clinical outcomes of patients with multiple organ failure requiring intensive care. Therefore, we retrospectively analyzed the clinical characteristics, risk factors, and relationship between the SOFA score and the prognosis of COVID-19 patients.Methods: Clinical variables were compared between patients with mild and severe COVID-19. Univariate and multivariate logistic regression analyses were performed to identify the risk factors for severe COVID-19. The Cox proportional hazards model was used to analyze risk factors for hospital-related death. Survival analysis was performed by the Kaplan-Meier method, and survival differences were assessed by the log-rank test. Receiver operating characteristic (ROC) curves of the SOFA score in different situations were drawn, and the area under the ROC curve was calculated.Results: The median SOFA score of all patients was 2 (IQR, 1-3). Patients with severe COVID-19 exhibited a significantly higher SOFA score than patients with mild COVID-19 [3 (IQR, 2-4) vs 1 (IQR, 0-1); P<0.001]. The SOFA score increased the risk of severe COVID-19, with an odds ratio of 5.851 (95% CI: 3.044-11.245; P<0.001). The area under the ROC curve (AUC) was used to evaluate the diagnostic accuracy of the SOFA score in predicting severe COVID-19 [cutoff value = 2; AUC = 0.908 (95% CI: 0.857-0.960); sensitivity: 85.20%; specificity: 80.40%] and the risk of death in COVID-19 patients [cutoff value = 5; AUC = 0.995 (95% CI: 0.985-1.000); sensitivity: 100.00%; specificity: 95.40%]. Regarding the 60-day mortality rates of patients in the two groups classified by the optimal cutoff value of the SOFA score (5), patients in the high SOFA score group (SOFA score ≥5) had a significantly greater risk of death than those in the low SOFA score group (SOFA score <5).Conclusion: The SOFA score could be used to evaluate the severity and 60-day mortality of COVID-19. The SOFA score may be an independent risk factor for in-hospital death.

scholarly journals Cardiac Arrest Survival Post-Electrocution – Management in a Low-Resource Emergency Department in Ghana: A Case Series

2021 ◽  
Vol 2 (2) ◽  
pp. 69-73
Author(s):  
: Nana Serwaa Agyeman Quao
Keyword(s):  
Emergency Department ◽  
Cardiac Arrest ◽  
Catchment Area ◽  
Early Recognition ◽  
Case Series ◽  
Protective Equipment ◽  
High Exposure ◽  
Supportive Management ◽  
Cardiac Arrest Survival ◽  
Electrical Injuries

Introduction The potential dangers of electrical injuries continue to increase since the commercial availability of electricity. Degrees of electrical injuries range from minor burns to cardiac arrest. Electrocution is cardiac arrest resulting from an electric shock. In Ghana, many electrocution cases are declared dead with little or no resuscitative measures. With the establishment of the emergency department (ED) at Komfo Anokye Teaching Hospital (KATH), such cases within the catchment area are being managed. We sought to describe the management of three (3) cases of electrocution admitted which were resuscitated at the KATH ED. Case Series We present three retrospective cases of electrocution involving two adults and one child presenting to the ED of KATH. None of them had any form of cardiopulmonary resuscitation (CPR) at the scene, or en route to the hospital, however, all cases received resuscitative measures of CPR, defibrillation, intubation and other supportive management, and were successfully discharged home in a few days with no major complications. Discussion Electrical injuries do occur; however, continuous education and caution should be taken especially whilst using electricity and electrical appliances. Workers with high exposure to electricity should emphasize maximum safety precautions and use of appropriate protective equipment. Home appliances should be well hidden and insulated to protect children. Early recognition of cardiac arrest, immediate initiation of CPR, availability of defibrillators improves outcomes in cardiac arrest post-electrocution.

Risk Factors for Peri-intubation Cardiac Arrest in a Pediatric Emergency Department

2020 ◽  
Vol Publish Ahead of Print ◽  
Author(s):  
Nicholas Pokrajac ◽  
Emily Sbiroli ◽  
Kathryn A. Hollenbach ◽  
Michael A. Kohn ◽  
Edwin Contreras ◽  
...  
Keyword(s):  
Risk Factors ◽  
Emergency Department ◽  
Cardiac Arrest ◽  
Pediatric Emergency ◽  
Pediatric Emergency Department

scholarly journals Cardiac Arrest Survival Postresuscitation In-Hospital (CASPRI) Score Predicts Neurological Favorable Survival in Emergency Department Cardiac Arrest

2021 ◽  
Vol 10 (21) ◽  
pp. 5131
Author(s):  
Jeffrey Che-Hung Tsai ◽  
Jen-Wen Ma ◽  
Shih-Chia Liu ◽  
Tzu-Chieh Lin ◽  
Sung-Yuan Hu
Keyword(s):  
Emergency Department ◽  
Cardiac Arrest ◽  
Coronary Angiography ◽  
Neurological Status ◽  
Survival Group ◽  
Resuscitated Patients ◽  
Favorable Neurological Outcome ◽  
Utstein Style ◽  
Cardiac Arrest Survival ◽  
Hospital Cardiac Arrest

Background: This study was conducted to identify the predictive factors for survival and favorable neurological outcome in patients with emergency department cardiac arrest (EDCA). Methods: ED patients who suffered from in-hospital cardiac arrest (IHCA) from July 2014 to June 2019 were enrolled. The electronic medical records were retrieved and data were extracted according to the IHCA Utstein-style guidelines. Results: The cardiac arrest survival post-resuscitation in-hospital (CASPRI) score was associated with survival, and the CASPRI scores were lower in the survival group. Three components of the CASPRI score were associated with favorable neurological survival, and the CASPRI scores were lower in the favorable neurological survival group of patients who were successfully resuscitated. The independent predictors of survival were presence of hypotension/shock, metabolic illnesses, short resuscitation time, receiving coronary angiography, and TTM. Receiving coronary angiography and low CASPRI score independently predicted favorable neurological survival in resuscitated patients. The performance of a low CASPRI score for predicting favorable neurological survival was fair, with an AUROCC of 0.77. Conclusions: The CASPRI score can be used to predict survival and neurological status of patients with EDCA. Post-cardiac arrest care may be beneficial for IHCA, especially in patients with EDCA.

scholarly journals The prognostic value of the SOFA score in patients with COVID-19: a retrospective, observational study

2020 ◽  
Author(s):  
Zheng Yang ◽  
Qinming Hu ◽  
Fei Huang ◽  
Shouxin Xiong ◽  
yi sun
Keyword(s):  
Risk Factors ◽  
Organ Failure ◽  
Roc Curve ◽  
Sofa Score ◽  
Proportional Hazards Model ◽  
Cox Proportional Hazards Model ◽  
Rank Test ◽  
Hospital Death ◽  
Cutoff Value ◽  
Risk Of Death

Abstract Background Patients with Coronavirus disease 2019 (COVID-19) have a high mortality rate, and thus, it is particularly important to predict the severity and prognosis of COVID-19. The Sequential Organ Failure Assessment (SOFA) score has been used to predict the clinical outcomes of patients with multiple organ failure requiring intensive care. Therefore, we retrospectively analyzed the clinical characteristics, risk factors, and relationship between the SOFA score and the prognosis of COVID-19 patients. Methods Clinical variables were compared between patients with mild and severe COVID-19. Univariate and multivariate logistic regression analyses were performed to identify the risk factors for severe COVID-19. The Cox proportional hazards model was used to analyze risk factors for hospital-related death. Survival analysis was performed by the Kaplan-Meier method, and survival differences were assessed by the log-rank test. Receiver operating characteristic (ROC) curves of the SOFA score in different situations were drawn, and the area under the ROC curve was calculated. Results The median SOFA score of all patients was 2 (IQR, 1–3). Patients with severe COVID-19 exhibited a significantly higher SOFA score than patients with mild COVID-19 [3 (IQR, 2–4) vs 1 (IQR, 0–1); P < 0.001]. The SOFA score increased the risk of severe COVID-19, with an odds ratio of 5.851 (95% CI: 3.044–11.245; P < 0.001). The area under the ROC curve (AUC) was used to evaluate the diagnostic accuracy of the SOFA score in predicting severe COVID-19 [cutoff value = 2; AUC = 0.908 (95% CI: 0.857–0.960); sensitivity: 85.20%; specificity: 80.40%] and the risk of death in COVID-19 patients [cutoff value = 5; AUC = 0.995 (95% CI: 0.985-1.000); sensitivity: 100.00%; specificity: 95.40%]. Regarding the 60-day mortality rates of patients in the two groups classified by the optimal cutoff value of the SOFA score (5), patients in the high SOFA score group (SOFA score ≥ 5) had a significantly greater risk of death than those in the low SOFA score group (SOFA score < 5). Conclusion The SOFA score could be used to evaluate the severity and 60-day mortality of COVID-19. The SOFA score may be an independent risk factor for in-hospital death.

AP040 Risk factors and early prognosis of cardiac arrest complicated acute coronary syndrome with ST-elevation in the emergency department

Resuscitation ◽  
2011 ◽  
Vol 82 ◽  
pp. S18-S19
Author(s):  
Bellili Sarra ◽  
Amira Feten ◽  
Souissi Sami ◽  
Ghazeli Hanen ◽  
Yahmadi Anour ◽  
...  
Keyword(s):  
Risk Factors ◽  
Emergency Department ◽  
Acute Coronary Syndrome ◽  
Cardiac Arrest ◽  
Coronary Syndrome ◽  
St Elevation

scholarly journals Prediction of Outcome in Critically Ill Elderly Patients using APACHE II and SOFA Scores

2012 ◽  
Vol 40 (3) ◽  
pp. 1114-1121 ◽  
Author(s):  
Q Qiao ◽  
G Lu ◽  
M Li ◽  
Y Shen ◽  
D Xu
Keyword(s):  
Elderly Patients ◽  
Critically Ill ◽  
Roc Curve ◽  
Sofa Score ◽  
Apache Ii ◽  
Apache Ii Score ◽  
Failure Assessment ◽  
Mortality Outcome ◽  
Lemeshow Test ◽  
The Difference

OBJECTIVE: Performances of the Acute Physiology and Chronic Health Evaluation II (APACHE II) score and the Sequential Organ Failure Assessment (SOFA) score were assessed in predicting mortality outcome in critically ill elderly patients. METHODS: Mean APACHE II and SOFA scores were compared in 106 intensive care unit patients aged > 65 years classified as survivors or deaths. The discriminatory ability of the scores was evaluated using the area under the receiver operating characteristic (ROC) curve. Calibration was assessed using the Hosmer—Lemeshow test. RESULTS: Mean APACHE II and SOFA scores in survivors were lower than in those who died. There was a positive correlation between the APACHE II and SOFA scores. The area under the ROC curve was 0.76 for the APACHE II score and ranged from 0.74 for the initial SOFA score to 0.98 for the maximum SOFA score. Hosmer—Lemeshow values for the APACHE II score and various SOFA scores indicated that predictions based on these scores closely fit the observed outcomes. CONCLUSIONS: APACHE II and SOFA scores can accurately predict mortality outcome in critically ill elderly patients, especially the maximum SOFA score and the difference between the maximum and initial SOFA scores.

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