Cardiac Arrest
Conditions
Keywords
cardiac arrest, hypothermia induced, intensive care unit
Brief summary
Even in patients with successful return of spontaneous circulation (ROSC), outcome after cardiac arrest remains poor. The overall in-hospital survival rate widely varies both worldwide and across communities, from 1 to 4 folds according to circumstances of arrest and post-resuscitation interventions. Several studies have already shown that early interventions performed after ROSC, such as treatment of the cause, targeted temperature management, optimal hemodynamic management and extra-corporeal life support in selected patients, could improve the outcome in post-cardiac arrest patients. However, the decision process regarding the allocation of these resources, in parallel with the management of patients' proxies, remains a complex challenge for physicians facing these situations. Consequently, several prediction models and scores have been developed in order to stratify the risk of unfavorable outcome and to discriminate the best candidates for post-resuscitation interventions. Overall, several scores exist, but external validation are lacking and direct comparisons are needed to assess relative interest of scoring systems. Indeed, establishing the optimal scoring system is crucial, for optimal treatment allocation and appropriate information to relatives.
Interventions
DIAGNOSTIC_TESTCalculation of early prognosis score
Early prognosis score will be calculated at intensive care unit admission for each patient based on clinical and biological values as required
Sponsors
AfterROSC
Study design
Observational model
COHORT
Time perspective
PROSPECTIVE
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
\- All adult patients, major, admitted to intensive care after out-of-hospital cardiac arrest and comatose (defined by Glasgow score ≤ 8) on admission.
Exclusion criteria
* cardiac arrest occurring intra-hospital, * minor patient, * major patient under guardianship, * protected persons, * prior inclusion in the study
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Determination of Area Under Curve of Cerebral Admission Hospital Prognosis (CAHP) Score at intensive care unit admission | Intensive Care Unit Admission (Usually 3 hours after cardiac arrest) | Determination of AUC for CAHP score as compare to Utstein style criteria. CAHP score range from 0 to 300 with higher score indicates poorer prognosis |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Determination of Area Under Curve of simplified CAHP Score at intensive care unit admission | Intensive Care Unit Admission (Usually 3 hours after cardiac arrest) | Determination of AUC for simplified CAHP score as compare to Utstein style criteria sCAHP score range from 0 to 150 with higher score indicates poorer prognosis |
| Determination of Area Under Curve of OHCA Score at intensive care unit admission | Intensive Care Unit Admission (Usually 3 hours after cardiac arrest) | Determination of AUC for OHCA score as compare to Utstein style criteria OHCA score range from -30 to 60 with higher score indicates poorer prognosis |
| Determination of Area Under Curve of CREST Score at intensive care unit admission | Intensive Care Unit Admission (Usually 3 hours after cardiac arrest) | Determination of AUC for CREST score as compare to Utstein style criteria CREST score range from 0 to 5 with higher score indicates poorer prognosis |
| Determination of Area Under Curve of modified CAHP Score at intensive care unit admission | Intensive Care Unit Admission (Usually 3 hours after cardiac arrest) | Determination of AUC for modified CAHP score as compare to Utstein style criteria mCAHP score range from 0 to 280 with higher score indicates poorer prognosis |
| Determination of Area Under Curve of TTM Score at intensive care unit admission | Intensive Care Unit Admission (Usually 3 hours after cardiac arrest) | Determination of AUC for TTM score as compare to Utstein style criteria TTM score range from -2 to 35 with higher score indicates poorer prognosis |
| Determination of Area Under Curve of NULL-PLEASE Score at intensive care unit admission | Intensive Care Unit Admission (Usually 3 hours after cardiac arrest) | Determination of AUC for NULL-PLEASE score as compare to Utstein style criteria NULL-PLEASE score range from 0 to 14 with higher score indicates poorer prognosis |
| Determination of calibration of each score | Intensive Care Unit Admission (Usually 3 hours after cardiac arrest) | Determination of calibration of: CAHP, sCAHP, mCAHP, OHCA, CREST, C-Graph, TTM and NULL-PLEASE score |
| Determination of Area Under Curve of C-Graph Score at intensive care unit admission | Intensive Care Unit Admission | Determination of AUC for C-Graph score as compare to Utstein style criteria C-Graph score range from 0 to 5 with higher score indicates poorer prognosis |
Countries
Belgium, France
Outcome results
None listed