Cardiac Arrest Survival Postresuscitation In-Hospital (CASPRI) Score Predicts Neurological Favorable Survival in Emergency Department Cardiac Arrest

Abstract

Background: This study was conducted to identify the predictive factors for survival and favorable neurological outcome in patients with emergency department cardiac arrest (EDCA). Methods: ED patients who suffered from in-hospital cardiac arrest (IHCA) from July 2014 to June 2019 were enrolled. The electronic medical records were retrieved and data were extracted according to the IHCA Utstein-style guidelines. Results: The cardiac arrest survival post-resuscitation in-hospital (CASPRI) score was associated with survival, and the CASPRI scores were lower in the survival group. Three components of the CASPRI score were associated with favorable neurological survival, and the CASPRI scores were lower in the favorable neurological survival group of patients who were successfully resuscitated. The independent predictors of survival were presence of hypotension/shock, metabolic illnesses, short resuscitation time, receiving coronary angiography, and TTM. Receiving coronary angiography and low CASPRI score independently predicted favorable neurological survival in resuscitated patients. The performance of a low CASPRI score for predicting favorable neurological survival was fair, with an AUROCC of 0.77. Conclusions: The CASPRI score can be used to predict survival and neurological status of patients with EDCA. Post-cardiac arrest care may be beneficial for IHCA, especially in patients with EDCA.

Predicting in-hospital cardiac arrest outcomes: CASPRI and GO-FAR scores

“…Chou et al and Che-Hung et al have conducted studies to investigate the usefulness of the CASPRI score for IHCA in the emergency department. The AUROC was 0.81 in the study conducted by Chou et al 10 and 0.77 in the study conducted by Tsai et al 11 In the present study, the AUROC of CASPRI score was 0.76, while slightly lower than some prior studies. However, the AUROC of CASPRI score for the prediction of a CPC score of 1 (discharge without neurological damage) was 0.78, indicating better predictive power for this outcome.…”

“…Additionally, the priority in the early stages of cardiac arrest is to treat the clinical problem that caused it and provide hemodynamic treatment, making it difficult to perform these tests. Moreover, different patient illness categories and clinical departments, along with the limited availability of multidisciplinary treatment and intensive care teams in some hospitals, hinder the implementation of standard integrated treatment after cardiac arrest 11 . In cases of patients with end-stage diseases or irreversible clinical deterioration, intensive treatment after cardiac arrest may not offer meaningful benefits due to limited life expectancy.…”

The usefulness of the CASPRI and the GO-FAR scores for predicting the neurological prognoses of patients who recovered spontaneous circulation after in-hospital cardiac arrest.

“…The neurological outcome of IHCA may be one of the questions most frequently asked by patient's guardians because it determines the direction of subsequent treatment and can affect the patient's quality of life. Chan [11] and 0.77 in the study conducted by Che-Hung et al [12] In the present study, the average CASPRI score of patients with a good neurological prognosis was 18.19 (cut-off value, 17). The area under the ROC (AUROC) of CASPRI score was 0.748, which is lower than those in the abovementioned three studies.…”

Artificial neural network-boosted Cardiac Arrest Survival Post-Resuscitation In-hospital (CASPRI) score accurately predicts outcome in cardiac arrest patients treated with targeted temperature management

“…Chan et al in their study, reported CASPRI score with an AUC of 0.802 for predicting favorable neurological outcomes 18 . This score has been validated using patients of East Asian descent, wherein the AUC for CASPRI score was 0.77–0.79 19 , 24 and was recommended as a good tool for categorizing patients with varying chances of hospital survival 25 . Consistent with the findings of these studies, in the present study, we report CASPRI score with an AUC of 0.811 for predicting favorable neurological outcomes in cardiac arrest patients who are treated with TTM.…”