Adrie et al reported an OHCA score for patients resuscitated after an out-of-hospital cardiac arrest. This can help to predict long-term outcome. The authors are from Delafontaine Hospital, University of Paris V, University of Paris VII, Jacques Cartier Institute and Troyes Hospital in France.
Patient selection: resuscitated after out-of-hospital cardiac arrest (OHCA)
Outcome: poor with cerebral performance categories (CPC 3 to 5), hospital death
Parameters:
(1) initial recorded rhythm
(2) no-flow interval in minutes, minimum 0.5 minutes
(3) low-flow interval in minutes, minimum 0.5 minutes
(4) serum creatinine in µmol/L
(5) arterial lactate in mmol/L
|
Parameter
|
Finding
|
Points
|
|
initial recorded rhythm
|
ventricular fibrillation or tachycardia
|
-13
|
|
|
other
|
0
|
|
no-flow interval
|
|
6 * LN(no flow)
|
|
low-flow interval
|
|
9 * LN(low flow)
|
|
serum creatinine
|
|
- 1434 / (creatinine)
|
|
arterial lactate
|
|
10 * LN(lactate)
|
OHCA score =
= SUM(points for all points)
X =
= (0.0936 * (score)) - 0.739
probability of poor outcome =
= 1 / (1 + EXP((-1) * X))
NOTE: The text (page 2841, column 2) says "probabillity of hospital death" but previously refers to probability of poor outcome (CPC 3-5).
|
Score
|
Probability Poor Outcome
|
|
2
|
25%
|
|
17.4
|
50%
|
|
32.5
|
75%
|
A line approximating the curve for poor outcome in Figure 2:
percent probability of poor outcome =
= (-0.00046 * ((score)^3)) + (0.031 * ((score)^2)) + (1.1 * (score)) + 23
Performance:
• The area under the ROC curve was 0.82 in hte development cohort and 0.88 in the validation cohort.
