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Tien JCC, Ching YHE, Tan HL, Lee JJ, Leong KLC. Outcomes of in-hospital cardiac arrests during and after office hours in a single tertiary centre in Singapore. Singapore Med J 2024:00077293-990000000-00096. [PMID: 38402592 DOI: 10.4103/singaporemedj.smj-2021-470] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/01/2022] [Accepted: 11/05/2022] [Indexed: 02/27/2024]
Abstract
INTRODUCTION In-hospital cardiac arrest (IHCA) is a significant healthcare burden with a paucity of data in Singapore. Various factors, including time of cardiac arrest, affect survival from acute resuscitation. METHODS This was a retrospective cohort study that evaluated the characteristics of patients who sustained an IHCA, including the Cardiac Arrest Survival Post Resuscitation In-hospital (CASPRI) scores, and the impact of arrest time in 220 consecutive cardiac arrests occurring in a tertiary hospital. The primary outcome was rate of return of spontaneous circulation (ROSC) post-IHCA, and the secondary outcome was 90-day survival. RESULTS The ROSC rate among patients with IHCA out of and during office hours was 69.5% and 75.4%, respectively (odds ratio [OR] 0.74, 95% confidence interval [CI] 0.39-1.42). There were no statistically significant differences between the CASPRI scores of both groups. After adjusted analysis, the OR of ROSC post-IHCA out of office hours as compared to that during office hours was 0.78 (95% CI 0.39-1.53). The 90-day survival rate of patients who had an IHCA out of and during office hours was 25.7% and 34.6%, respectively (OR 0.65, 95% CI 0.32-1.34). The adjusted OR of 90-day survival was 0.66 (0.28-1.59). CONCLUSION The results of this observational study did not show an association between the timing of cardiac arrest and the rate of ROSC or 90-day survival.
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Affiliation(s)
- Jong-Chie Claudia Tien
- Division of Anesthesiology, Department of Surgical Intensive Care, Singapore General Hospital, Singapore
| | - Yi Hao Edgarton Ching
- Department of Clinical Governance and Quality, Singapore General Hospital, Singapore
| | - Hui Li Tan
- Specialty Nursing, Singapore General Hospital, Singapore
| | - Jun Jie Lee
- Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore
| | - Kah Lai Carrie Leong
- Department of Respiratory and Critical Care Medicine, Singapore General Hospital, Singapore
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Akatsuka M, Tatsumi H, Masuda Y. Clinical features and outcomes of in-hospital cardiac arrest in code blue events: a retrospective observational study. Front Cardiovasc Med 2023; 10:1247340. [PMID: 38028464 PMCID: PMC10658708 DOI: 10.3389/fcvm.2023.1247340] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2023] [Accepted: 10/18/2023] [Indexed: 12/01/2023] Open
Abstract
Background In-hospital cardiac arrest (IHCA) is a critical medical event with outcomes less researched compared to out-of-hospital cardiac arrest. This retrospective observational study aimed to investigate key aspects of IHCA epidemiology and prognosis in patients with Code Blue activation. Methods This retrospective observational study enrolled patients with Code Blue events in our hospital between January 2010 and October 2019. Participant characteristics, including age and sex, and IHCA characteristics, including the time of cardiac arrest, witnessed event, bystander cardiopulmonary resuscitation (CPR), initial shockable rhythm, vital signs at 1 and 6 h before IHCA, survival to hospital discharge (SHD), and the cardiac arrest survival postresuscitation in-hospital (CASPRI) score were included in univariate and multivariate logistic regression analyses with SHD as the primary endpoint. Results From the 293 Code Blue events that were activated during the study period, 81 participants were enrolled. Overall, the SHD rate was 28.4%, the median CPR duration was 14 (interquartile range, 6-28) min, and the rate of initial shockable rhythm was 19.8%. There were significant intergroup differences between the SHD and non-SHD groups in the CPR duration, shockable rhythm, and CASPRI score on univariate logistic regression analysis. Multivariate logistic regression analysis showed that the CASPRI score was the most accurate predictive factor for SHD (OR = 0.98, p = 0.006). Conclusions The CASPRI score is associated with SHD in patients with IHCA during Code Blue events. Therefore, the CASPRI score of IHCA patients potentially constitutes a simple, useful adjunctive tool for the management of post-cardiac arrest syndrome.
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Affiliation(s)
- Masayuki Akatsuka
- Department of Intensive Care Medicine, School of Medicine, Sapporo Medical University, Sapporo, Japan
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Jung J, Ryu JH, Shon S, Min M, Hyun TG, Chun M, Lee D, Lee M. Predicting in-hospital cardiac arrest outcomes: CASPRI and GO-FAR scores. Sci Rep 2023; 13:18087. [PMID: 37872179 PMCID: PMC10593798 DOI: 10.1038/s41598-023-44312-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2022] [Accepted: 10/06/2023] [Indexed: 10/25/2023] Open
Abstract
It is important to predict the neurological prognoses of in-hospital cardiac arrest (IHCA) patients immediately after recovery of spontaneous circulation (ROSC) to make further critical management. The aim of this study was to confirm the usefulness of the Cardiac Arrest Survival Post-Resuscitation In-hospital (CASPRI) and Good Outcome Following Attempted Resuscitation (GO-FAR) scores for predicting the IHCA immediately after the ROSC. This is a retrospective analysis of patient data from a tertiary general hospital located in South Korea. A total of 488 adult patients who had IHCA and achieved sustained ROSC from September 2016 to August 2021 were analyzed to compare effectiveness of the CASPRI and GO-FAR scores related to neurologic prognosis. The primary outcome was Cerebral Performance Category (CPC) score at discharge, defined as a CPC score of 1 or 2. The secondary outcomes were survival-to-discharge and normal neurological status or minimal neurological damage at discharge. Of the 488 included patients, 85 (20.8%) were discharged with good prognoses (CPC score of 1 or 2). The area under the receiver operating characteristic curve of CASPRI score for the prediction of a good neurological outcome was 0.75 (95% CI 0.69-0.81), whereas that of GO-FAR score was 0.67 (95% CI 0.60-0.73). The results of this study show that these scoring systems can be used for timely and satisfactory prediction of the neurological prognoses of IHCA patients after ROSC.
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Affiliation(s)
- Jonghee Jung
- Department of Emergency Medicine, Pusan National University Yangsan Hospital, Kumoh-ro 20, Mulgum-up, Yangsan-si, Gyeongsangnam-do, 50612, Korea
| | - Ji Ho Ryu
- Department of Emergency Medicine, Pusan National University Yangsan Hospital, Kumoh-ro 20, Mulgum-up, Yangsan-si, Gyeongsangnam-do, 50612, Korea
- Department of Emergency Medicine, Pusan National University School of Medicine, Yangsan-si, Gyeongsangnam-do, 50612, Korea
| | - Seungwoo Shon
- Department of Emergency Medicine, Pusan National University Yangsan Hospital, Kumoh-ro 20, Mulgum-up, Yangsan-si, Gyeongsangnam-do, 50612, Korea
| | - Munki Min
- Department of Emergency Medicine, Pusan National University Yangsan Hospital, Kumoh-ro 20, Mulgum-up, Yangsan-si, Gyeongsangnam-do, 50612, Korea
- Department of Emergency Medicine, Pusan National University School of Medicine, Yangsan-si, Gyeongsangnam-do, 50612, Korea
| | - Tae Gyu Hyun
- Department of Emergency Medicine, Pusan National University Yangsan Hospital, Kumoh-ro 20, Mulgum-up, Yangsan-si, Gyeongsangnam-do, 50612, Korea
| | - Mose Chun
- Department of Emergency Medicine, Pusan National University Yangsan Hospital, Kumoh-ro 20, Mulgum-up, Yangsan-si, Gyeongsangnam-do, 50612, Korea
| | - Daesup Lee
- Department of Emergency Medicine, Pusan National University Yangsan Hospital, Kumoh-ro 20, Mulgum-up, Yangsan-si, Gyeongsangnam-do, 50612, Korea
| | - Minjee Lee
- Department of Emergency Medicine, Pusan National University Yangsan Hospital, Kumoh-ro 20, Mulgum-up, Yangsan-si, Gyeongsangnam-do, 50612, Korea.
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Chou SY, Bamodu OA, Chiu WT, Hong CT, Chan L, Chung CC. Artificial neural network-boosted Cardiac Arrest Survival Post-Resuscitation In-hospital (CASPRI) score accurately predicts outcome in cardiac arrest patients treated with targeted temperature management. Sci Rep 2022; 12:7254. [PMID: 35508580 PMCID: PMC9068683 DOI: 10.1038/s41598-022-11201-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2021] [Accepted: 04/14/2022] [Indexed: 01/04/2023] Open
Abstract
Existing prognostic models to predict the neurological recovery in patients with cardiac arrest receiving targeted temperature management (TTM) either exhibit moderate accuracy or are too complicated for clinical application. This necessitates the development of a simple and generalizable prediction model to inform clinical decision-making for patients receiving TTM. The present study explores the predictive validity of the Cardiac Arrest Survival Post-resuscitation In-hospital (CASPRI) score in cardiac arrest patients receiving TTM, regardless of cardiac event location, and uses artificial neural network (ANN) algorithms to boost the prediction performance. This retrospective observational study evaluated the prognostic relevance of the CASPRI score and applied ANN to develop outcome prediction models in a cohort of 570 patients with cardiac arrest and treated with TTM between 2014 and 2019 in a nationwide multicenter registry in Taiwan. In univariate logistic regression analysis, the CASPRI score was significantly associated with neurological outcome, with the area under the receiver operating characteristics curve (AUC) of 0.811. The generated ANN model, based on 10 items of the CASPRI score, achieved a training AUC of 0.976 and validation AUC of 0.921, with the accuracy, precision, sensitivity, and specificity of 89.2%, 91.6%, 87.6%, and 91.2%, respectively, for the validation set. CASPRI score has prognostic relevance in patients who received TTM after cardiac arrest. The generated ANN-boosted, CASPRI-based model exhibited good performance for predicting TTM neurological outcome, thus, we propose its clinical application to improve outcome prediction, facilitate decision-making, and formulate individualized therapeutic plans for patients receiving TTM.
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Affiliation(s)
- Szu-Yi Chou
- Graduate Institute of Neural Regenerative Medicine, College of Medical Science and Technology, Taipei Medical University, Taipei, Taiwan, ROC.,Ph.D. Program for Neural Regenerative Medicine, College of Medical Science and Technology, Taipei Medical University and National Health Research Institutes, Taipei, Taiwan, ROC
| | - Oluwaseun Adebayo Bamodu
- Department of Medical Research & Education, Shuang Ho Hospital, Taipei Medical University, New Taipei City, 235, Taiwan, ROC.,Department of Urology, Shuang Ho Hospital, Taipei Medical University, New Taipei City, 235, Taiwan, ROC.,Department of Hematology & Oncology, Shuang Ho Hospital, Taipei Medical University, New Taipei City, 235, Taiwan, ROC
| | - Wei-Ting Chiu
- Department of Neurology, Shuang Ho Hospital, Taipei Medical University, 291, Zhongzheng Road, Zhonghe District, New Taipei City, 235, Taiwan, ROC.,Department of Neurology, School of Medicine, College of Medicine, Taipei Medical University, Taipei City, 110, Taiwan, ROC.,Division of Critical Care Medicine, Department of Emergency and Critical Care Medicine, Taipei Medical University-Shuang Ho Hospital, New Taipei City, 235, Taiwan, ROC
| | - Chien-Tai Hong
- Department of Neurology, Shuang Ho Hospital, Taipei Medical University, 291, Zhongzheng Road, Zhonghe District, New Taipei City, 235, Taiwan, ROC.,Department of Neurology, School of Medicine, College of Medicine, Taipei Medical University, Taipei City, 110, Taiwan, ROC
| | - Lung Chan
- Department of Neurology, Shuang Ho Hospital, Taipei Medical University, 291, Zhongzheng Road, Zhonghe District, New Taipei City, 235, Taiwan, ROC. .,Department of Neurology, School of Medicine, College of Medicine, Taipei Medical University, Taipei City, 110, Taiwan, ROC.
| | - Chen-Chih Chung
- Department of Neurology, Shuang Ho Hospital, Taipei Medical University, 291, Zhongzheng Road, Zhonghe District, New Taipei City, 235, Taiwan, ROC. .,Department of Neurology, School of Medicine, College of Medicine, Taipei Medical University, Taipei City, 110, Taiwan, ROC. .,Graduate Institute of Biomedical Informatics, College of Medical Science and Technology, Taipei Medical University, Taipei City, 110, Taiwan, ROC.
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