Nishioka et al reported models for predicting neurological outcome at 90 days after an out-of-hospital cardiac arrest. One model does not use laboratory values while another does. The authors are from multiple institutions in Japan.
Patient selection: out-of-hospital cardiac arrest
Outcome: unfavorable (CPC >= 3) at 90 days
Parameters:
(1) age in years
(2) initial rhythm at scene
(3) bystander CPR
(4) shock during cardiac arrest
(5) administration of adrenaline during cardiac arrest
(6) advanced airway management during cardiac arrest
(7) first documented rhythm in hospital
(8) Glasgow coma motor score, from 1 to 6
(9) no flow time in minutes
(10) low flow time in minutes
|
Parameter
|
Finding
|
Points
|
|
age in years
|
|
0.0421 * (age)
|
|
initial rhythm
|
VF or pVT
|
0
|
|
|
PEA
|
0.6420
|
|
|
asystole
|
0.765
|
|
bystander CPR
|
no
|
0
|
|
|
yes
|
-0.0478
|
|
shock during arrest
|
no
|
0
|
|
|
yes
|
-1.2712
|
|
adrenaline given
|
no
|
0
|
|
|
yes
|
1.4157
|
|
airway management
|
no
|
0
|
|
|
yes
|
0.5051
|
|
first documented rhythm
|
VF or pVT
|
0
|
|
|
PEA (pulseless electrical activity)
|
1.099
|
|
|
asystole
|
1.788
|
|
|
ROSC
|
0
|
|
GCS motor score
|
1
|
1.184
|
|
|
>= 2
|
0
|
|
no flow time
|
< 9 minutes
|
0
|
|
|
>= 10 minutes
|
0.1727
|
|
|
not witnessed
|
0
|
|
low flow time
|
|
0.545 * LN(time)
|
where:
• The type of log transformation of the low flow time was not given. It was assumed to be natural logarithm.
• VF or pVT are shockable rhythms.
value of X =
= SUM(points for all of the parameters) - 5.2892
probability of poor neurologic outcome =
= 1 / (1+EXP((-1) * X))
Performance:
• The area under the ROC curve is 0.95.
