Background The Cardiac Arrest Survival Post-Resuscitation In-hospital (CASPRI) and Good Outcome Following Attempted Resuscitation (GO-FAR) scores are used for predicting the outcomes of cardiac arrest. The CASPRI score was developed for the prediction of neurological outcomes after in-hospital cardiac arrest (IHCA), whereas the GO-FAR score is used to predict survival after cardiac arrest. The aim of this study was to confirm the usefulness of the CASPRI and GOFAR scores for predicting the neurological prognoses in-hospital cardiac arrest (IHCA) patients immediately after the return of spontaneous circulation (ROSC). Methods This was a retrospective analysis of patient data from a tertiary general hospital. A total of 488 adult patients who had IHCA and achieved sustained ROSC from September 2016 to August 2021 were analyzed to compare effectiveness of the CASPRI and GO-FAR scores related to neurologic prognoses. The primary outcome was Cerebral Performance Category (CPC) score at discharge. Results Of the 488 included patients, 85 (20.8%) were discharged with good prognoses (CPC score 1 or 2). The area under the receiver operating characteristic curve of CASPRI score for the prediction of a good neurological outcome was 0.748 (OR, 0.86; 95% CI, 0.82-0.90), whereas that of GO-FAR score was 0.668 (OR, 0.95; 95% CI, 0.93-0.97). Conclusion The CASPRI and GO-FAR scores include factors related to a patient's clinical condition and situations when CPR occurred. These scoring systems can be used for timely and satisfactory prediction of the neurological prognoses of IHCA patients after ROSC.
Mushroom poisoning is increasing worldwide, as well as the incidence of fatal mushroom poisoning. Several new syndromes associated with mushroom poisoning have been described in the literature. Notably, 1 of the newly identified mushroom poisonings is Russula subnigricans poisoning. R subnigricans can be classified as causing a delayed-onset rhabdomyolytic syndrome as patients with this severe poisoning present with severe rhabdomyolysis, acute kidney injury, and cardiomyopathy. However, there are only a few reports on the toxicity of R subnigricans. We recently treated 6 patients with R subnigricans mushroom poisoning, of whom 2 died. The 2 patients showed severe rhabdomyolysis, metabolic acidosis, acute renal failure, electrolyte imbalance, and irreversible shock, which caused their deaths. Mushroom poisoning should be considered in the evaluation of rhabdomyolysis of unknown origin. In addition, in cases of mushroom poisoning with severe rhabdomyolysis, R subnigricans poisoning should be promptly identified.
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