Early prediction of prognosis in out-of-hospital cardiac arrest.
Of 347 victims of out-of-hospital cardiac arrest 196 (56.5%) died before and 109 (31.4%) after admission to hospital, while 42 patients (12.1%) were discharged alive. The 37 patients (10.7%) discharged without severe hypoxic brain damage were assigned to the group with "good", the remaining 310 patients to the group with "poor outcome". From results of stepwise logistic regression, a score was derived to specifically identify victims with poor prognosis (values in brackets = score points; cutpoint: score greater than 3 points): age less than or equal to 70 (0), 71-80 (1), greater than 80 (2); ECG ventricular fibrillation (0), other (1); no aspiration (0), aspiration (1); pupils round (0), not round (1); gasping (0), apnea (1); bystander resuscitation--yes (0), no (1). Evaluation of the score revealed a specificity of 100% (0.95 confidence interval: 80%-100%) and predictive value of 100% (0.95 confidence interval: 95%-100%). A predictive score for specific identification of victims with poor prognosis can contribute to decision making in out-of-hospital cardiac arrest.
Kentsch
M
M
Department of Internal Medicine, Medical University Lübeck, Federal Republic of Germany.
Stendel
M
M
Berkel
H
H
Mueller-Esch
G
G
D000368:Aged; D003657:Decision Making; D004562:Electrocardiography; D004632:Emergency Medical Services / Q000592:standards*; D005260:Female; D005860:Germany, West / Q000453:epidemiology; D006323:Heart Arrest / Q000401:mortality* / Q000503:physiopathology / Q000628:therapy; D006801:Humans; D008297:Male; D008875:Middle Aged; D010043:Outcome and Process Assessment, Health Care; D011237:Predictive Value of Tests; D011379:Prognosis; D012151:Resuscitation / Q000592:standards*; D016019:Survival Analysis