Specific and non-specific prognostic scores in patients with out-of-hospital cardiac arrest caused by ST-segment elevation myocardial infarction: A comparative study - 11/03/25
Graphical abstract |
Highlights |
• | Acute coronary syndromes are the main causes of OHCA. |
• | OHCA prognostic scores were mostly developed in all-comers. |
• | No accuracy differences between a STEMI-specific and three all-comer OHCA scores. |
• | Main all-comer prognostic factors hold strong prognostic value in STEMI-related OHCA. |
Abstract |
Background |
Patients resuscitated after out-of-hospital cardiac arrest (OHCA) have a poor prognosis, with high death rates. Multiple scoring systems have been developed to predict survival in all-comers with OHCA. Acute coronary syndromes and ST-segment elevation myocardial infarction (STEMI) are the primary causes of OHCA. Recently, a specific prognostic score (Tran risk model) was developed for patients with STEMI-related OHCA.
Aim |
To compare the accuracy of established non-STEMI-specific prognostic scores (OHCA, modified CAHP and NULL-PLEASE) with the Tran risk model in predicting in-hospital death among patients with STEMI-related OHCA.
Methods |
This was an observational single-centre study including 315 consecutive patients treated for STEMI-related OHCA. The OHCA score was calculated for 310 patients (98.4%), the NULL-PLEASE and modified CAHP (mCAHP) scores were calculated for 308 patients (97.8%) and the Tran risk model score was calculated for 306 patients (97.1%). A C-statistic analysis was performed to determine score performance.
Results |
The area under the curve (AUC) for the Tran risk model was 0.75 (95% confidence interval [CI] 0.69–0.79). The AUCs for the OHCA, mCAHP and NULL-PLEASE scores were 0.74 (95% CI 0.69–0.80), 0.74 (95% CI 0.69–0.80) and 0.76 (95% CI 0.71–0.82), respectively. There was no significant difference in AUCs between the Tran risk model and the mCAHP score (P=0.95), the NULL-PLEASE score (P=0.42) or the OHCA score (P=0.93). Similarly, no significant difference was observed between the mCAHP, NULL-PLEASE and OHCA scores. Predictors of death were no-flow duration, diabetes, blood lactate, femoral access and age>75 years.
Conclusions |
The OHCA, NULL-PLEASE and mCAHP scores and the Tran risk model showed moderate to good performance in predicting in-hospital death in patients with STEMI-related OHCA. No differences in accuracy were found between non-STEMI-specific scores and the Tran risk model developed for patients with STEMI-related OHCA.
Le texte complet de cet article est disponible en PDF.Keywords : Out-of-hospital cardiac arrest, Prognostic score, STEMI
Plan
| ☆ | X post (Tweet): In STEMI-related OHCA, the STEMI-specific Tran mortality risk model (AUC 0.75) showed similar accuracy to non-STEMI-specific scores: OHCA (AUC 0.74), CAHP (0.74), and NULL-PLEASE (0.76). No significant differences. Key predictors: no-flow time, age>75, diabetes, lactate, femoral access. |
Vol 118 - N° 3
P. 161-169 - mars 2025 Retour au numéro
Article précédent
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