Abstract 17497: Risk Stratification of Patients With Out of Hospital Cardiac Arrest without ST-Segment Elevation: An Initial Exploratory Risk Score-The ‘PEA’ Score
Introduction: Out-of-hospital cardiac arrest (OHCA) affects over 325,000 adults each year in the United States, with survival rates of about 10.6%. Predicting risk of mortality in patients who achieve return of spontaneous circulation (ROSC) remains a challenge. While scoring tools to predict the risk of mortality in OHCA patients exist, risk stratification specifically in the patient with OHCA and no ST elevation on ECG (NSTE) has not been explored.
Hypothesis: A simple risk model can be used to predict in-hospital mortality in patients presenting with OHCA and NSTE.
Methods: Patient-level data were obtained from the Nationwide Inpatient Sample (NIS) from 2008-2011. A stepwise logistic regression model with backward elimination was used to determine the contribution of all candidate covariates. We assigned risk factors identified by multivariable analysis weighted points proportional to the logarithmic transformation of the β regression coefficient values. A risk score was then calculated for each patient in the derivation cohort, and validated with patients in the validation cohort. We used Stata 12.0SE (StataCorp, College Station, TX). A P value of <0.05 was considered significant.
Results: A total of 97,042 patients presenting to the hospital with OHCA and NSTE were examined. Among these, 58,066 patients (59.8%) died before hospital discharge. Three independent prognostic factors were identified, and each was assigned a number of points proportional to its regression coefficient: Pulseless (non-ventricular fibrillation) arrest (1 point), Elderly (Age greater than 85 years) (1 point), and Acidosis (1 point).The c- statistic for the PEA score point system was 0.61 (95% CI 0.60-0.62, p<0.001].
Conclusions: A novel risk model can predict in-hospital mortality in patients presenting with OHCA and NSTE. This simple score can be used on initial presentation to the hospital and may help to inform healthcare teams and families regarding patients’ prognoses.
Author Disclosures: S.W. Haider: None. S. Chatterjee: None. P. Sardar: None. J. Tamis-Holland: None.
- © 2016 by American Heart Association, Inc.