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Seewald S, Wnent J, Lefering R, Fischer M, Bohn A, Jantzen T, Brenner S, Masterson S, Bein B, Scholz J, Gräsner JT. CaRdiac Arrest Survival Score (CRASS) - A tool to predict good neurological outcome after out-of-hospital cardiac arrest. Resuscitation 2019; 146:66-73. [PMID: 31730900 DOI: 10.1016/j.resuscitation.2019.10.036] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2019] [Revised: 10/29/2019] [Accepted: 10/29/2019] [Indexed: 10/25/2022]
Abstract
AIM The aim of this study was to develop a score to predict the outcome for patients brought to hospital following out-of-hospital cardiac arrest (OHCA). METHODS All patients recorded in the German Resuscitation Registry (GRR) who suffered OHCA 2010-2017, who had ROSC or ongoing CPR at hospital admission were included. The study population was divided into development (2010-2016: 7985) and validation dataset (2017: 1806). Binary logistic regression analysis was used to derive the score. The probability of hospital discharge with good neurological outcome was defined as 1/(1 + e-X), where X is the weighted sum of independent variables. RESULTS The following variables were found to have a significant positive (+) or negative (-) impact: age 61-70 years (-0·5), 71-80 (-0·9), 81-90 (-1·3) and > = 91 (-2·3); initial PEA (-0·9) and asystole (-1·4); presumable trauma (-1·1); mechanical CPR (-0·3); application of adrenalin > 0 - < 2 mg (-1·1), 2 - <4 mg (-1·6), 4 - < 6 mg (-2·1), 6 - < 8 mg (-2·5) and > = 8 mg (-2·8); pre emergency status without previous disease (+0·5) or minor disease (+0·2); location at nursing home (-0·6), working place/school (+0·7), doctor's office (+0·7) and public place (+0·3); application of amiodarone (+0·4); hospital admission with ongoing CPR (-1·9) or normotension (+0·4); witnessed arrest (+0·6); time from collapse until start CPR 2 - < 10 min (-0·3) and > = 10 min (-0·5); duration of CPR <5 min (+0·6). The AUC in the development dataset was 0·88 (95% CI 0·87-0·89) and in the validation dataset 0·88 (95% CI 0·86-0·90). CONCLUSION The CaRdiac Arrest Survival Score (CRASS) represents a tool for calculating the probability of survival with good neurological function for patients brought to hospital following OHCA.
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Affiliation(s)
- S Seewald
- Department of Anesthesiology and Intensive Care Medicine, University Hospital Schleswig-Holstein, Campus Kiel, Arnold-Heller-Straße 3, building 12, Kiel, 24105, Germany; Institute for Emergency Medicine, University Hospital Schleswig-Holstein, Campus Kiel, Arnold-Heller-Straße 3, building 808, Kiel, 24105, Germany.
| | - J Wnent
- Department of Anesthesiology and Intensive Care Medicine, University Hospital Schleswig-Holstein, Campus Kiel, Arnold-Heller-Straße 3, building 12, Kiel, 24105, Germany; Institute for Emergency Medicine, University Hospital Schleswig-Holstein, Campus Kiel, Arnold-Heller-Straße 3, building 808, Kiel, 24105, Germany; University of Namibia, School of Medicine, Private Bag 13301, Windhoek, Namibia, Germany
| | - R Lefering
- University Witten/Herdecke, Faculty of Health, Institute for Research in Operative Medicine, Ostmerheimer Straße 200, Cologne, 51109, Germany
| | - M Fischer
- Department of Anesthesiology and Intensive Care, Klinik am Eichert, Eichertstraße 3, Göppingen, 73035, Germany
| | - A Bohn
- City of Münster Fire Department, York-Ring 25, Münster, 48159, Germany; Department of Anesthesiology, Intensive Care and Pain Medicine, University Hospital Münster, Albert-Schweitzer-Campus 1, building A1, York-Ring 25, Münster, 48149, Germany
| | - T Jantzen
- Interhospital-Transfer-Service Mecklenburg-Vorpommern, German Red Cross Parchim, Ventschowerstraße 1, Cambs, 19067, Germany
| | - S Brenner
- Department of Anesthesiology and Intensive Care Medicine, University Hospital Dresden, Fetscherstraße 74, Dresden, 01307, Germany
| | - S Masterson
- National Ambulance Service Lead - Strategy and Evaluation, St. Eunan's Hall, St. Conal's Hospital, Letterkenny, Co. Donegal, Ireland and Discipline of General Practice School of Medicine, National University of Ireland Galway F92 XK84, Ireland
| | - B Bein
- Department of Anesthesiology and Intensive Care Medicine, Asklepios Klinik St. Georg, Lohmühlenstraße 5, Hamburg, 20099, Germany
| | - J Scholz
- University Hospital Schleswig-Holstein, Arnold-Heller-Straße 3, Kiel, 24105, Germany
| | - J T Gräsner
- Institute for Emergency Medicine, University Hospital Schleswig-Holstein, Campus Kiel, Arnold-Heller-Straße 3, building 808, Kiel, 24105, Germany
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