External validation of a risk classification at the emergency department of post-cardiac arrest syndrome patients undergoing targeted temperature management

Autor: Takayuki Ogura, Mitsunobu Nakamura, Kazuki Nishida, Naoyuki Matsuda, Taku Iwami, Mitsuaki Nishikimi, Shigeyuki Matsui, Kunihiko Takahashi
Jazyk: angličtina
Rok vydání: 2019
Předmět:
Male
medicine.medical_specialty
Post-cardiac arrest syndrome
medicine.medical_treatment
Risk classification
Acute medicine
030204 cardiovascular system & hematology
Emergency Nursing
Targeted temperature management
Therapeutic normothermia
Risk Assessment
Sensitivity and Specificity
Prognostic score
03 medical and health sciences
0302 clinical medicine
Japan
Hypothermia
Induced
Health Status Indicators
Humans
Medicine
Neurological prognosis
Therapeutic hypothermia
Registries
Post cardiac arrest
High severity
rCAST
Aged
business.industry
External validation
030208 emergency & critical care medicine
Recovery of Function
Emergency department
Middle Aged
Prognosis
Emergency medicine
Emergency Medicine
Female
CAST
Emergency Service
Hospital
Cardiology and Cardiovascular Medicine
business
Out-of-Hospital Cardiac Arrest
Zdroj: Resuscitation. 140:135-141
ISSN: 0300-9572
Popis: Introduction There are no established risk classification for post-cardiac arrest syndrome (PCAS) patients at the Emergency Department (ED) undergoing targeted temperature management (TTM). The aim of this study was to externally validate a simplified version of our prognostic score, the “post-Cardiac Arrest Syndrome for Therapeutic hypothermia score” (revised CAST [rCAST]) and estimate the predictive accuracy of the risk classification based on it. Methods For the external validation, we used data from an out-of-hospital cardiac arrest (OHCA) registry of the Japanese Association for Acute Medicine (JAAM), which is a multicenter, prospective registry of OHCA patients across Japan. Eligible patients were PCAS patients treated with TTM at 33–36 °C between June 2014 and December 2015. We validated the accuracy of rCAST for predicting the neurological outcomes at 30 and 90 days. Results Among the 12,024 OHCA patients, the data of 460 PCAS patients treated by TTM were eligible for the validation. The areas under the curve of rCAST for predicting the neurological outcomes at 30 and 90 days were 0.892 and 0.895, respectively. The estimated sensitivity and specificity of the risk categories for the outcomes were as follows: 0.95 (95% CI: 0.92–0.98) and 0.47 (0.40–0.55) for the low (rCAST: ≤5.5), 0.62 (0.56–0.68) and 0.48 (0.40–0.55) for the moderate (rCAST: 6.0–14.0), and 0.57 (0.51–0.63) and 0.95 (0.91–0.98) for the high severity category (rCAST: ≥14.5). Conclusions The rCAST was useful for predicting the neurological outcomes with high accuracy in PCAS patients, and the three grades was developed for a risk classification based on the rCAST.
Databáze: OpenAIRE
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