Ebell et al developed the Prognosis After Resuscitation (PAR) score to evaluate patients undergoing cardiopulmonary resuscitation (CPR). This is based on the Pre-Arrest Morbidity Score (PAM, above).
Patient selection: in-hospital CPR
Parameters:
(1) cancer
(2) sepsis on hospital admission
(3) homebound
(4) pneumonia on hospital admission
(5) serum creatinine
(6) age in years
(7) acute myocardial infarction (MI)
|
Parameter |
Finding |
Points |
|
cancer |
none |
0 |
|
|
non-metastatic |
3 |
|
|
metastatic |
10 |
|
sepsis on admission |
absent |
0 |
|
|
present |
5 |
|
homebound |
absent |
0 |
|
|
present |
5 |
|
pneumonia on admission |
absent |
0 |
|
|
present |
3 |
|
serum creatinine |
<= 130 mmol/L |
0 |
|
|
> 130 mmol/L (1.47 mg/dL) |
3 |
|
age in years |
<= 70 years |
0 |
|
|
> 70 years |
2 |
|
acute MI |
absent |
0 |
|
|
present |
-2 |
total PAR score =
= SUM(points for all 7 parameters)
Interpretation:
• minimum score: -2
• maximum score: 28
• O'Keefe and Ebell found no survivors if the score was > 4.
• Bowker et al used a PAR > 7 as indicating futile resuscitation.
Performance:
• The score has a low sensitivity (29% at a cutoff > 7) but high specificity. The attitude of physicians is that resuscitation even if the chances of success are low is more acceptable than not resuscitating someone who could be saved.
Specialty: Cardiology
ICD-10: ,
