Clinical Validation of Cardiac Arrest Hospital Prognosis (CAHP) Score and MIRACLE2 Score to Predict Neurologic Outcomes after Out-of-Hospital Cardiac Arrest
Abstract
:1. Introduction
2. Methods
2.1. Study Population
2.2. Data Collection
2.3. Statistical Analysis
3. Results
4. Discussion
5. Conclusions
Supplementary Materials
Author Contributions
Funding
Institutional Review Board Statement
Data Availability Statement
Acknowledgments
Conflicts of Interest
References
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Demographic Characteristics | Poor Neurologic Outcome | Favorable Neurologic Outcome | p |
---|---|---|---|
n = 167 | n = 33 | ||
Age | 66.2 ± 16.2 | 64.6 ± 10.9 | 0.593 |
Male sex | 101 | 19 | 0.756 |
MIRACLE2 | 5.9 ± 1.2 | 4.9 ± 1.4 | <0.001 |
CAHP score | 233.3 ± 36.1 | 194.8 ± 38.0 | <0.001 |
Epinephrine dose (mg) | 6.5 ± 6.0 | 4.1 ± 4.9 | <0.001 |
Public location | 44 | 12 | 0.242 |
Witness | 133 | 22 | 0.103 |
Bystander CPR | 60 | 10 | 0.536 |
Shockable rhyme | 9 | 6 | 0.011 |
Primary PCI | 23 | 15 | <0.001 |
Collapse to BLS (min) | 7.1 ± 5.0 | 5.3 ± 4.1 | 0.010 |
BLS to ROSC | 27.4 ± 15.1 | 15.5 ± 10.6 | <0.001 |
ECMO | 13 | 2 | 0.731 |
pH | 7.017 ± 0.179 | 7.115 ± 0.176 | 0.005 |
History of myocardial infarction | 31 | 3 | 0.186 |
Diabetes | 74 | 12 | 0.399 |
Malignancy | 17 | 1 | 0.190 |
Liver cirrhosis | 10 | 0 | 0.149 |
Renal insufficiency | 56 | 11 | 0.982 |
COPD | 18 | 2 | 0.409 |
Variables | OR | 95% CI | p | |
---|---|---|---|---|
MIRACLE2 | 0.654 | 0.446 | 0.936 | 0.020 |
Epinephrine dose (mg) | 0.894 | 0.797 | 0.98 | 0.015 |
Primary PCI | 6.47 | 2.584 | 16.769 | <0.001 |
pH | 3.486 | 0.289 | 47.207 | 0.329 |
Variables | OR | 95% CI | p | |
---|---|---|---|---|
CAHP | 0.978 | 0.963 | 0.992 | 0.003 |
Epinephrine dose (mg) | 0.851 | 0.714 | 0.981 | 0.024 |
Primary PCI | 8.479 | 3.05 | 25.085 | <0.001 |
pH | 0.966 | 0.059 | 17.109 | 0.981 |
Favorable Neurologic Outcomes | |||||
---|---|---|---|---|---|
Situation | Threshold (Points) | AUC | Lower | Upper | p |
MIRACLE2 | 5.5 | 0.704 | 0.61 | 0.797 | <0.001 |
CAHP score | 223.4 | 0.773 | 0.688 | 0.858 | <0.001 |
MIRACLE2 Score (n = 200) | * CAHP Score (n = 185) | ||||
---|---|---|---|---|---|
Assessment Using MIRACLE2 > 5.5 | Poor Neurologic Outcome | Favorable Neurologic Outcome | Assessment Using CAHP > 223 | Poor Neurologic Outcome | Favorable Neurologic Outcome |
No. of positive results | 108 | 11 | No. of positive results | 105 | 6 |
No. of negative results | 59 | 22 | No. of negative results | 49 | 25 |
Sensitivity, % (95% CI) | 64.7 (56.9–71.9) | Sensitivity, % (95% CI) | 68.2 (60.2–75.5) | ||
Specificity, % (95% CI) | 66.7 (48.2–82.0) | Specificity, % (95% CI) | 80.6 (62.5–92.6) | ||
PPV, % | 90.8 (85.6–94.2) | PPV, % | 94.6 (88.6–98.0) | ||
NPV, % | 27.2 (21.4–33.9) | NPV, % | 33.8 (23.2–45.7) |
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Wu, J.-Z.; Chiu, W.-C.; Wu, W.-T.; Chiu, I.-M.; Huang, K.-C.; Hung, C.-W.; Cheng, F.-J. Clinical Validation of Cardiac Arrest Hospital Prognosis (CAHP) Score and MIRACLE2 Score to Predict Neurologic Outcomes after Out-of-Hospital Cardiac Arrest. Healthcare 2022, 10, 578. https://doi.org/10.3390/healthcare10030578
Wu J-Z, Chiu W-C, Wu W-T, Chiu I-M, Huang K-C, Hung C-W, Cheng F-J. Clinical Validation of Cardiac Arrest Hospital Prognosis (CAHP) Score and MIRACLE2 Score to Predict Neurologic Outcomes after Out-of-Hospital Cardiac Arrest. Healthcare. 2022; 10(3):578. https://doi.org/10.3390/healthcare10030578
Chicago/Turabian StyleWu, Jun-Zuo, Wei-Che Chiu, Wei-Ting Wu, I-Min Chiu, Kuo-Chen Huang, Chih-Wei Hung, and Fu-Jen Cheng. 2022. "Clinical Validation of Cardiac Arrest Hospital Prognosis (CAHP) Score and MIRACLE2 Score to Predict Neurologic Outcomes after Out-of-Hospital Cardiac Arrest" Healthcare 10, no. 3: 578. https://doi.org/10.3390/healthcare10030578