Abstract 19623: Validation of the Pittsburgh Cardiac Arrest Category Illness Severity Score
Introduction: The purpose of the current study was to both prospectively and retrospectively validate an early post-cardiac arrest illness severity classification ability to predict the likelihood of survival to hospital discharge and good functional outcome.
Hypothesis: We hypothesized that the Pittsburgh Cardiac Arrest Category (PCAC) would be predictive of post-arrest survival and good functional outcome after adjusting for other determinants of outcome.
Methods: The PCAC is a 4-level illness severity score that was found to be strongly predictive of patient outcomes in the initial derivation study. We assigned PCAC scores to consecutive in-hospital and out-of-hospital cardiac arrest subjects treated at two tertiary care centers between January 2011 and September 2013. We made these assignments prospectively at Site 1 and retrospectively at Site 2. Our primary outcome of interest was survival to hospital discharge. Secondary outcomes were favorable discharge disposition (home or acute rehabilitation), Cerebral Performance Category (CPC) and modified Rankin Scale (mRS) at hospital discharge. We tested the association of PCAC with each outcome using unadjusted and multivariable logistic regression.
Results: We included 607 patients admitted with cardiac arrest during the study period (393 at Site 1 and 214 at Site 2). The populations at the two sites differed in age, arrest location, presenting rhythm, use of induced hypothermia and distribution of PCAC. PCAC was associated with survival (unadjusted odds ratio (OR) Site 1: 0.33 (95% confidence interval (CI) 0.27-0.41)) Site 2: 0.32 (95%CI 0.24-0.43)) even after adjustment for other clinical variables (adjusted OR Site 1: 0.32 (95%CI 0.25-0.41)) Site 2: 0.31 (95%CI 0.22-0.44)). PCAC was similarly predictive of secondary outcomes.
Conclusions: Our results confirm that PCAC is strongly predictive of survival and good functional outcome after cardiac arrest.
Author Disclosures: P.J. Coppler: None. J. Elmer: None. L. Caldaron: None. A. Sabedra: None. A. Doshi: None. C.W. Callaway: None. J.C. Rittenberger: None. C. Dezfulian: None.
- © 2014 by American Heart Association, Inc.