medical decision support medical decision support
Sign In

Decision Support Tool of McCullough et al in Cardiac Arrest Victims

Purpose: To evaluate a patient shortly after a cardiac arrest to predict short term outcome using the cardiac arrest score of McCullough et al.

Description

McCullough et al developed a simple score for evaluating a patient who has undergone a cardiac arrest. The score uses 3 simple clinical findings available shortly after resuscitation that can predict the short term outcome for the patient. The authors are from several hospitals with the lead author from Henry Ford Hospital in Detroit.


Parameters:

(1) initial systolic blood pressure

(2) time to return of spontaneous circulation

(3) initial neurologic assessment

 

Parameter

Finding

Points

initial systolic blood pressure

< 90 mm Hg

0

 

>= 90 mm Hg

1

time to return of spontaneous circulation

>= 25 minutes

0

 

< 25 minutes

1

initial neurologic assessment

comatose or simple reflexes only

0

 

spontaneous limb movement to fully alert and oriented

1

 

cardiac arrest score =

= SUM(points for all 3 parameters)

 

Interpretation:

• minimum score: 0

• maximum score: 3

• The higher the score, the better the better the outcome, both in survival to discharge and probability of neurologic recovery (little or no neurologic impairment).

 

Score

Probability of Survival to Discharge

Probability of Neurologic Recovery

0

10%

3%

1

29%

17%

2

58%

57%

3

82%

89%

from Thompson (1998)

 

Performance:

• The level of agreement for the initial and validation data sets was 0.98 and 0.99.

• The area under the operator curve was > 0.90 for both outcomes.


To read more or access our algorithms and calculators, please log in or register.

Specialty

Objective

ICD-10