CREST Model of Bascom et al for Predicting Circulatory Death of a Patient With Cardiac Arrest and Without ST-Segment Elevation Myocardial Infarction (STEMI)
Bascom et al reported the CREST model for early prediction of circulatory death in a patient resuscitated from a cardiac arrest not due to ST-segment elevation myocardial infarction (STEMI). The authors are from the International Cardiac Arrest Registry (INTCAR).
Patient selection: S/P cardiac arrest not due to STEMI
Outcome: circulatory etiology death
Parameters:
(1) history of coronary artery disease (C)
(2) nonshockable rhythm (R)
(3) left ventricular ejection fraction on admission in percent (E)
(4) shock at presentation (S)
(5) ischemic time in minutes (T)
Parameter
Finding
Points
history of coronary artery disease
no
0
yes
1
nonshockable rhythm
no
0
yes
1
left ventricular ejection fraction
>= 30%
0
< 30%
1
shock
absent
0
present
1
ischemic time
<= 25 minutes
0
> 25 minutes
1
total score =
= SUM(points for all 5 parameters)
Interpretation:
• minimum score: 0
• maximum score: 5
• The higher the score the greater the mortality rate.
Score
Mortality Rate
0
7-10%
1
10-11%
2
20-23%
3
30-32%
4
30-39%
5
50-56%
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