- 期刊
Does it Matter Where the Heart Stops? rCAST Score Performance in Predicting Outcomes of in-hospital Cardiac Arrest patients
摘要
Objectives: The characteristics of patients with in-hospital cardiac arrest (IHCA) are generally considered to be different from those with out-of-hospital cardiac arrest (OHCA). The revised post-Cardiac Arrest Syndrome for Therapeutic hypothermia (rCAST) score has been proven to be a good predictive score for neurologic outcomes and mortality in OHCA patients who receive therapeutic temperature management (TTM); however, its application in IHCA patients has yet to be evaluated. Methods: In this retrospective study, we enrolled adult post-cardiac arrest syndrome (PCAS) patients who had an IHCA and received TTM from 2017 to 2021 at our hospital. Their medical records were extracted to calculate the rCAST score and analyze their outcomes. Results: A total of 37 patients were enrolled for analysis. The average rCAST score was 5.6±3.6, and 51.4% and 48.6% of the patients were classified into the low and moderate severity categories, respectively. The areas under the curves for the rCAST score were 0.780 (95% confidence interval [CI]: 0.614-0.899) to predict poor neurologic outcomes, and 0.809 (95% CI: 0.647-0.919) to predict mortality at day 28. Only those patients in the low severity category were associated with survival and favorable neurologic outcome benefits. Conclusion: Our preliminary results suggest that the rCAST score had moderate accuracy in predicting poor neurologic outcomes and mortality at 28 days in IHCA patients receiving TTM. Further large-scale studies are warranted to confirm these findings.