title: Global Registry of Acute Coronary Events risk score predicts mortality and neurological outcome in out-of hospital cardiac arrest.
abstract: OBJECTIVE
  The aim of this study was to assess the usefulness of the Global Registry of Acute Coronary Events (GRACE) risk score in predicting in-hospital mortality and neurological outcome of patients resuscitated after out-of-hospital cardiac arrest (OHCA).
  
  
  METHODS
  We retrospectively analyzed the data of patients admitted to our hospital between October 2009 and October 2015 with OHCA and shockable initial cardiac rhythm who were resuscitated via conventional cardiopulmonary resuscitation. We calculated the GRACE risk score on admission and assessed its usefulness in predicting in-hospital mortality and neurological outcome.
  
  
  RESULTS
  Among 91 patients, 42 (46%) had acute myocardial infarction (AMI), 19 (21%) died in-hospital, and 52 (57%) had favorable neurological outcome. Among all the study patients, GRACE risk score was lower in survivors than in non-survivors (median 211 [interquartile range 176-240] vs. 266 [219-301], p<0.001, respectively) and in favorable than in unfavorable neurological outcome group (202 [167-237] vs. 242 [219-275], p<0.001, respectively). Multivariate analysis showed significant association between GRACE risk score and favorable neurological outcome (odds ratio, 0.975; 95% confidence interval, 0.961-0.990). Areas under receiver-operating characteristic curves, that describe the accuracy of GRACE risk score in predicting in-hospital mortality and favorable neurological outcome, were both 0.79.
  
  
  CONCLUSIONS
  GRACE risk score may predict the in-hospital mortality and neurological outcome associated with resuscitated patients with OHCA and shockable initial cardiac rhythm, regardless of the cause of arrest.
authors.affiliation: Senri Critical Care Medical Center, Osaka Saiseikai Senri Hospital, 1-1-6, Tsukumodai, Suita-City, Osaka, 565-0862, Japan. Electronic address: sonnyboy@tempo.ocn.ne.jp.
authors.forename: Takayuki
authors.initials: T
authors.lastname: Otani
authors.affiliation: Senri Critical Care Medical Center, Osaka Saiseikai Senri Hospital, 1-1-6, Tsukumodai, Suita-City, Osaka, 565-0862, Japan.
authors.forename: Hirotaka
authors.initials: H
authors.lastname: Sawano
authors.affiliation: Senri Critical Care Medical Center, Osaka Saiseikai Senri Hospital, 1-1-6, Tsukumodai, Suita-City, Osaka, 565-0862, Japan.
authors.forename: Tomoaki
authors.initials: T
authors.lastname: Natsukawa
authors.affiliation: Senri Critical Care Medical Center, Osaka Saiseikai Senri Hospital, 1-1-6, Tsukumodai, Suita-City, Osaka, 565-0862, Japan.
authors.forename: Reiko
authors.initials: R
authors.lastname: Matsuoka
authors.affiliation: Senri Critical Care Medical Center, Osaka Saiseikai Senri Hospital, 1-1-6, Tsukumodai, Suita-City, Osaka, 565-0862, Japan.
authors.forename: Masaya
authors.initials: M
authors.lastname: Morita
authors.affiliation: Senri Critical Care Medical Center, Osaka Saiseikai Senri Hospital, 1-1-6, Tsukumodai, Suita-City, Osaka, 565-0862, Japan.
authors.forename: Yasuyuki
authors.initials: Y
authors.lastname: Hayashi
mesh_terms: D000368:Aged; D016887:Cardiopulmonary Resuscitation / Q000401:mortality*; D002560:Cerebrovascular Circulation; D004632:Emergency Medical Services / Q000706:statistics & numerical data; D005260:Female; D017052:Hospital Mortality / Q000639:trends*; D006801:Humans; D038622:Internationality; D007564:Japan; D008297:Male; D008875:Middle Aged; D009422:Nervous System Diseases / Q000401:mortality* / Q000503:physiopathology; D058687:Out-of-Hospital Cardiac Arrest / Q000401:mortality* / Q000503:physiopathology; D011379:Prognosis; D012042:Registries; D012189:Retrospective Studies; D018570:Risk Assessment
keywords: Cerebral performance category; GRACE risk score; Out-of-hospital cardiac arrest