Maupain et al reported the Cardiac Arrest Hospital Prognosis (CAHP) score for evaluating a patient admitted to the hospital after an out-of-hospital cardiac arrest. The authors are from multiple institutions in Paris.
Patient selection: out-of-hospital cardiac arrest, admitted to the ICU
Outcome: Cerebral Performance Categories 3, 4 or 5 at hospital discharge
Parameters:
(1) age in years, from 10 to 100
(2) arrest setting
(3) shockable rhythm
(4) time between collapse and start of basic life support in minutes, from 0 to 30
(5) time from start of basic life support to ROSC in minutes, from 0 to 100
(6) arterial pH, from 6.3 to 7.6
(7) mg of epinephrine administered
points for age =
= (1.08556 * (age)) - 10.8556
points for collapse to BLS =
= (2.859 * (time))
points for BLS to ROSC =
= (0.777 * (time))
points for arterial pH =
= 584.62 - (76.923 * (pH))
|
Parameter
|
Finding
|
Points
|
|
arrest setting
|
public
|
0
|
|
|
home
|
23.6
|
|
shockable rhythm
|
no
|
26.5
|
|
|
yes
|
0
|
|
epinephrine dose
|
0 mg
|
0
|
|
|
1 or 2 mg
|
27.2
|
|
|
>= 3 mg
|
43.9
|
total score =
= SUM(points for all of the parameters)
Interpretation:
• minimum score: 0
• maximum score: 457.6
|
Total Score
|
Risk Group
|
Percent Unfavorable Outcome
|
|
0 to 150
|
low
|
39%
|
|
151 to 199
|
medium
|
81%
|
|
>= 200
|
high
|
100%
|
value of X =
= (0.04878 * (score)) - 6.66
probability of unfavorable neurologic outcome =
= 1 / (1 + EXP((-1) * X))
Performance:
• The area under the ROC curve is 0.93.
