Article ; Online: A novel score to predict in-hospital mortality for patients with acute coronary syndrome and out-of-hospital cardiac arrest: the FACTOR study.
Clinical research in cardiology : official journal of the German Cardiac Society
2024 Volume 113, Issue 4, Page(s) 591–601
Abstract: Introduction: Acute coronary syndromes (ACS) represent a substantial global healthcare challenge. In its most severe form, it can lead to out-of-hospital cardiac arrest (OHCA). Despite medical advancements, survival rates in OHCA patients remain low. ... ...
| Abstract | Introduction: Acute coronary syndromes (ACS) represent a substantial global healthcare challenge. In its most severe form, it can lead to out-of-hospital cardiac arrest (OHCA). Despite medical advancements, survival rates in OHCA patients remain low. Further, the prediction of outcomes in these patients poses a challenge to all health care providers involved. This study aims at developing a score with variables available on admission to assess in-hospital mortality of patients with OHCA undergoing coronary angiography. Method: All patients with OHCA due to ACS admitted to a tertiary care center were included. A multivariate logistic regression analysis was conducted to explore the association between clinical variables and in-hospital all-cause mortality. A scoring system incorporating variables available upon admission to assess individual patients' risk of in-hospital mortality was developed (FACTOR score). The score was then validated. Results: A total of 291 patients were included in the study, with a median age of 65 [56-73] years, including 47 women (16.2%). The in-hospital mortality rate was 41.2%. A prognostic model was developed in the derivation cohort (n = 138) and included the following variables: age, downtime, first detected rhythm, and administration of epinephrine. The area under the curve for the FACTOR score was 0.823 (95% CI 0.737-0.894) in the derivation cohort and 0.828 (0.760-0.891) in the validation cohort (n = 153). Conclusion: The FACTOR score demonstrated a reliable prognostic tool for health care providers in assessing in-hospital mortality of OHCA patients. Early acknowledgement of a poor prognosis may help in patient management and allocation of resources. |
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| MeSH term(s) | Humans ; Female ; Middle Aged ; Aged ; Out-of-Hospital Cardiac Arrest/diagnosis ; Out-of-Hospital Cardiac Arrest/therapy ; Acute Coronary Syndrome/diagnosis ; Acute Coronary Syndrome/therapy ; Hospital Mortality ; Prognosis ; Hospitalization ; Cardiopulmonary Resuscitation | |||||
| Language | English | |||||
| Publishing date | 2024-02-08 | |||||
| Publishing country | Germany | |||||
| Document type | Journal Article | |||||
| ZDB-ID | 2213295-8 | |||||
| ISSN | 1861-0692 ; 1861-0684 | |||||
| ISSN (online) | 1861-0692 | |||||
| ISSN | 1861-0684 | |||||
| DOI | 10.1007/s00392-023-02367-1 | |||||
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| Database | MEDical Literature Analysis and Retrieval System OnLINE |
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