Performance of OHCA, NULL-PLEASE and CAHP scores to predict survival in Out-of-Hospital Cardiac Arrest due to acute coronary syndrome

Vincent Pham; Driss Laghlam; Olivier Varenne; Florence Dumas; Alain Cariou; Fabien Picard

doi:10.1016/j.resuscitation.2021.07.011

Performance of OHCA, NULL-PLEASE and CAHP scores to predict survival in Out-of-Hospital Cardiac Arrest due to acute coronary syndrome

Resuscitation. 2021 Sep:166:31-37. doi: 10.1016/j.resuscitation.2021.07.011. Epub 2021 Jul 22.

Authors

Vincent Pham¹, Driss Laghlam², Olivier Varenne³, Florence Dumas⁴, Alain Cariou⁵, Fabien Picard⁶

Affiliations

¹ Department of Cardiology, Cochin Hospital, Hôpitaux Universitaire Paris Centre, Assistance Publique des Hôpitaux de Paris, Paris, France.
² Medical Intensive Care Unit, Cochin Hospital, Hôpitaux Universitaire Paris Centre, Assistance Publique des Hôpitaux de Paris, Paris, France.
³ Department of Cardiology, Cochin Hospital, Hôpitaux Universitaire Paris Centre, Assistance Publique des Hôpitaux de Paris, Paris, France; Université de Paris, Paris, France; INSERM U970, Paris Cardiovascular Research Center (PARCC), European Georges Pompidou Hospital, Paris, France.
⁴ Université de Paris, Paris, France; INSERM U970, Paris Cardiovascular Research Center (PARCC), European Georges Pompidou Hospital, Paris, France; Emergency Department, Cochin Hospital, Hôpitaux Universitaire Paris Centre, Assistance Publique des Hôpitaux de Paris, Paris, France.
⁵ Medical Intensive Care Unit, Cochin Hospital, Hôpitaux Universitaire Paris Centre, Assistance Publique des Hôpitaux de Paris, Paris, France; Université de Paris, Paris, France; INSERM U970, Paris Cardiovascular Research Center (PARCC), European Georges Pompidou Hospital, Paris, France.
⁶ Department of Cardiology, Cochin Hospital, Hôpitaux Universitaire Paris Centre, Assistance Publique des Hôpitaux de Paris, Paris, France; Université de Paris, Paris, France; INSERM U970, Paris Cardiovascular Research Center (PARCC), European Georges Pompidou Hospital, Paris, France. Electronic address: Fabien.picard@aphp.fr.

PMID: 34302930
DOI: 10.1016/j.resuscitation.2021.07.011

Abstract

Aim: Out-of-hospital Cardiac Arrest (OHCA) carries a poor prognostic with high mortality rates and multiple scoring systems have been developed to assess its prognostic. This study sought to evaluate the performance of three prognostic scores to predict survival in OHCA patients due to acute coronary syndrome (ACS).

Methods and results: This is an observational, monocentric study including 386 consecutive patients treated for OHCA due to ACS, treated by percutaneous coronary intervention, between 2007 and 2019. The OHCA, NULL-PLEASE and CAHP scores were calculated respectively for 370 patients (95.9%), 371 patients (96.1%) and 350 patients (90.7%). A C-statistic analysis was performed to determine score performance. The areas under the curve for the OHCA, NULL-PLEASE and CAHP scores were 0.861 (95% CI, 0.823-0.898), 0.789 (95% CI, 0.744-0.834) and 0.830 (95% CI, 0.788-0.872) respectively demonstrating good performance. The OHCA score performed better than the NULL-PLEASE score (p = 0.001), and there was no difference between the CAHP and the NULL-PLEASE score (p = 0.062) nor between the OHCA and the CAHP score (p = 0.105).

Conclusion: The OHCA score, the NULL-PLEASE score and the CAHP score performed well in predicting in-hospital death in patients presenting OHCA secondary to ACS. The NULL-PLEASE score is the easiest to use but performed less accurately than the OHCA score.

Keywords: Acute coronary syndrome; Cardiac arrest; Survival predicition score.

Publication types

Observational Study

MeSH terms

Acute Coronary Syndrome* / complications
Cardiopulmonary Resuscitation*
Hospital Mortality
Humans
Out-of-Hospital Cardiac Arrest* / therapy
Prognosis