Validating the GO-FAR score: predicting in-hospital cardiac arrest outcomes in the Middle East.

IF 2 Q2 EMERGENCY MEDICINE International Journal of Emergency Medicine Pub Date : 2024-10-22 DOI:10.1186/s12245-024-00749-4
David O Alao, Yaman Hukan, Nada Mohammed, Kinza Moin, Resshme K Sudha, Arif Alper Cevik, Fikri M Abu-Zidan
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Abstract

Introduction and aim: External validations of the Good Outcome Following Attempted Resuscitation (GO-FAR) score have been in populations where Do Not Attempt Resuscitation (DNAR) is practised. We aim to externally validate the GO-FAR score in a population without a DNAR order.

Methods: We studied patients ≥ 18 years old who had an In-hospital cardiac arrest (IHCA) with known outcomes at Al Ain Hospital from January 2017 to December 2019, excluding those who died in the emergency department. Studied variables included demography, location, response time, code duration, initial rhythm, primary diagnosis, admission vital signs, GO FAR score variables, discharge status, and functional outcomes as determined by the cerebral performance category score ranging from 1 (good cerebral performance) to 5 (brain death).

Results: 366 patients were studied; 66.7% were males. The median (IQR) age was 70 (55-81) years. Cardiac and respiratory causes were the primary diagnoses in 89 (24.6%) and 67 (18.5%), respectively. IHCA occurred in critical areas such as the intensive care unit, high dependency unit and coronary care unit in 206 (80.8%) patients. The majority, 308 (91.8%), had a non-shockable rhythm, and a return of spontaneous circulation was achieved in 159 (43.4%) of the patients. Thirty-one (8.5%) patients survived to hospital discharge, and 20 (5.5%) patients had cerebral performance category scores of 1 and 2. The area under the curve of the ROC for survival to discharge with good functional outcome was 0.74 (95% CI 0.59-0.88). The best cut-off point for predicting survival with a good neurological outcome was a GO-FAR score of < 4, having a sensitivity of 0.81, a specificity of 0.7, a positive likelihood ratio of 2.7 and a negative likelihood ratio of 0.27.

Conclusions: A GO-FAR score of less than 4 predicts survival with a good neurological outcome in a healthcare system with an all-inclusive patient population with no DNAR practice.

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验证 GO-FAR 评分:预测中东地区院内心脏骤停的预后。
导言和目的:外部对尝试复苏后良好结果(GO-FAR)评分的验证是在实施非尝试复苏(DNAR)的人群中进行的。我们的目标是在没有 DNAR 命令的人群中对 GO-FAR 评分进行外部验证:我们研究了 2017 年 1 月至 2019 年 12 月期间在艾因医院发生院内心脏骤停(IHCA)并有已知结果的≥18 岁患者,不包括在急诊科死亡的患者。研究变量包括人口统计学、地点、响应时间、代码持续时间、初始心律、主要诊断、入院生命体征、GO FAR评分变量、出院状态以及根据脑功能类别评分确定的功能结果,脑功能类别评分从1分(脑功能良好)到5分(脑死亡)不等:共研究了 366 名患者,其中 66.7% 为男性。中位数(IQR)年龄为 70(55-81)岁。分别有 89 人(24.6%)和 67 人(18.5%)主要诊断为心脏病和呼吸系统疾病。有 206 名(80.8%)患者的 IHCA 发生在重症监护病房、高依赖病房和冠心病监护病房等关键区域。大多数患者(308 人,占 91.8%)的心律是非休克性的,其中 159 人(占 43.4%)恢复了自主循环。31名患者(8.5%)存活到出院,20名患者(5.5%)的脑功能分类评分为1分和2分。功能结果良好的出院存活率的 ROC 曲线下面积为 0.74(95% CI 0.59-0.88)。预测神经功能预后良好的存活率的最佳分界点是 GO-FAR 评分结论:GO-FAR 评分低于 4 分可预测在一个医疗系统中神经功能良好的存活率,该医疗系统中的所有患者均无 DNAR 实践。
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来源期刊
CiteScore
4.60
自引率
0.00%
发文量
63
审稿时长
13 weeks
期刊介绍: The aim of the journal is to bring to light the various clinical advancements and research developments attained over the world and thus help the specialty forge ahead. It is directed towards physicians and medical personnel undergoing training or working within the field of Emergency Medicine. Medical students who are interested in pursuing a career in Emergency Medicine will also benefit from the journal. This is particularly useful for trainees in countries where the specialty is still in its infancy. Disciplines covered will include interesting clinical cases, the latest evidence-based practice and research developments in Emergency medicine including emergency pediatrics.
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