Factors affecting outcomes in patients with cardiac arrest who receive target temperature management: The multi-center TIMECARD registry

Chang, Chih-Heng; Tsai, Min‐Shan; Kuo, Li‐Kuo; Hsu, Hsin-Hui; Huang, Wei-Chun; Lai, Chih-Hung; Shih, Ming‐Chieh; Huang, Chien-Hua

doi:10.1016/j.jfma.2021.04.006

Cited by 12 publications

(17 citation statements)

References 38 publications

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“…This retrospective cohort study used clinical data from medical records obtained from the Taiwan Network of Targeted Temperature Management for Cardiac Arrest (TIMECARD) registry 14 . TIMECARD registry is a nationwide multicenter registry project conducted from January 2014 and September 2019 in 9 medical centers in Taiwan.…”

Section: Methodsmentioning

confidence: 99%

“…All eligible patients were treated using the TTM protocol consistent with the consensus of scientific statement from the Taiwan Society of Emergency & Critical Care Medicine 12 . The variables were retrieved from archived patients’ registry data based on the updated Utstein Resuscitation Registry template, and included baseline characteristics, comorbidities, coupled with information on the cardiac arrest event, etiology, post-arrest care, and the outcomes 12 , 14 , 20 . Modeled after the CASPRI score development and validation studies, which to the best of our knowledge, employed retrospective determination of pre- and post-arrest CPC score for predicting neurological outcomes for patients with cardiac arrest, the CPC score in our study was retrospectively determined from patients’ information garnered from family members and/or medical records by the research investigator, who is also consultant neurologist in each medical center 14 , 19 – 22 .…”

Section: Methodsmentioning

confidence: 99%

“…A favorable neurological outcome was defined as CPC score of 1–2 (conscious and alert with good or moderate cerebral performance) at the time of discharge, while poor outcome was defined as CPC score of 3–5 (severe neurological disability, persistent vegetative state, or death) 12 , 14 , 20 – 22 .…”

Section: Methodsmentioning

confidence: 99%

“…The CASPRI score (Table S1 ) was calculated for each patient as earlier described by Chan et al in the original development and internal validation study 18 . In TIMECARD registry, all clinical information of interventions prior to the time of cardiac arrest were excluded 14 , thus, mechanical ventilation, indicated as one variable of the CASPRI score 18 , was not included in the analysis. To calculate the CASPRI score for OHCA patients, arrest location was scored 3 points, being the score for patients from non-monitored unit 18 .…”

Section: Methodsmentioning

confidence: 99%

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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

Chou

Bamodu

Chiu

et al. 2022

Sci Rep

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Existing prognostic models to predict the neurological recovery in patients with cardiac arrest receiving targeted temperature management (TTM) either exhibit moderate accuracy or are too complicated for clinical application. This necessitates the development of a simple and generalizable prediction model to inform clinical decision-making for patients receiving TTM. The present study explores the predictive validity of the Cardiac Arrest Survival Post-resuscitation In-hospital (CASPRI) score in cardiac arrest patients receiving TTM, regardless of cardiac event location, and uses artificial neural network (ANN) algorithms to boost the prediction performance. This retrospective observational study evaluated the prognostic relevance of the CASPRI score and applied ANN to develop outcome prediction models in a cohort of 570 patients with cardiac arrest and treated with TTM between 2014 and 2019 in a nationwide multicenter registry in Taiwan. In univariate logistic regression analysis, the CASPRI score was significantly associated with neurological outcome, with the area under the receiver operating characteristics curve (AUC) of 0.811. The generated ANN model, based on 10 items of the CASPRI score, achieved a training AUC of 0.976 and validation AUC of 0.921, with the accuracy, precision, sensitivity, and specificity of 89.2%, 91.6%, 87.6%, and 91.2%, respectively, for the validation set. CASPRI score has prognostic relevance in patients who received TTM after cardiac arrest. The generated ANN-boosted, CASPRI-based model exhibited good performance for predicting TTM neurological outcome, thus, we propose its clinical application to improve outcome prediction, facilitate decision-making, and formulate individualized therapeutic plans for patients receiving TTM.

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Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

See 2 more Smart Citations

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

Chou

Bamodu

Chiu

et al. 2022

Sci Rep

View full text Add to dashboard Cite

show abstract

“…There was still unobservable between-study heterogeneity, especially in terms of long-term survival outcomes. Third, post-arrest care is associated with long-term outcome [ 54 , 56 ]. However, the lack of post-arrest management characteristics in most studies precluded further analysis.…”

Section: Discussionmentioning

confidence: 99%

Comparison between Prehospital Mechanical Cardiopulmonary Resuscitation (CPR) Devices and Manual CPR for Out-of-Hospital Cardiac Arrest: A Systematic Review, Meta-Analysis, and Trial Sequential Analysis

Chiang

Lim

Lai

et al. 2022

JCM

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In pre-hospital settings, efficient cardiopulmonary resuscitation (CPR) is challenging; therefore, the application of mechanical CPR devices continues to increase. However, the evidence of the benefits of using mechanical CPR devices in pre-hospital settings for adult out-of-hospital cardiac arrest (OHCA) is controversial. This meta-analysis compared the effects of mechanical and manual CPR applied in the pre-hospital stage on clinical outcomes after OHCA. Cochrane Library, PubMed, Embase, and ClinicalTrials.gov were searched from inception until October 2021. Studies comparing mechanical and manual CPR applied in the pre-hospital stage for survival outcomes of adult OHCA were eligible. Data abstraction, quality assessment, meta-analysis, trial sequential analysis (TSA), and grading of recommendations, assessment, development, and evaluation were conducted. Seven randomized controlled and 15 observational studies were included. Compared to manual CPR, pre-hospital use of mechanical CPR showed a positive effect in achieving return of spontaneous circulation (ROSC) and survival to admission. No difference was found in survival to discharge and discharge with favorable neurological status, with inconclusive results in TSA. In conclusion, pre-hospital use of mechanical CPR devices may benefit adult OHCA in achieving ROSC and survival to admission. With low certainty of evidence, more well-designed large-scale randomized controlled trials are needed to validate these findings.

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Variation in practice for out‐of‐hospital cardiac arrest treated with percutaneous coronary intervention in England and Wales

Rashid

Kinnaird

Ludman

et al. 2022

Cathet Cardio Intervent

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Objectives: We assessed the association between total center volume, operator volume, and out-of-hospital cardiac arrest (OHCA) percutaneous coronary intervention (PCI) volume.Background: Variations between OHCA PCI volume, hospital total PCI, and primary PCI volume are not well studied and are unlikely to be clinically justifiable. Methods: Patients undergoing PCI for the acute coronary syndrome (ACS) between January 1, 2014, and March 31, 2019, in England and Wales were grouped as OHCA PCI and non-OHCA PCI. Spearman's correlation was used to determine the degree of correlation between each hospital PCI volume and OHCA PCI volume.Results: Out of 250,088 PCI procedures undertaken for ACS, 12,016 (4.8%) were performed for OHCA, and 238,072 (95.2%) were non-OHCA PCI procedures. The OHCA PCI group were younger [mean age (SD) 63.2 (12.3) and 65.6 (12.5, p < 0.001)], less likely to be female (20.2% vs. 26.9%, p < 0.001) or Black, Asian, and Minority Ethnicity (11.5% vs. 14.8%, p < 0.001) compared to the non-OHCA PCI group. Although there was a degree of correlation between total PCI and OHCA PCI, there was wide variation for both ACS cohort (Spearman correlation R 2 = 0.50) and total PCI volume (Spearman correlation R 2 = 0.60). Furthermore, the correlation between primary PCI volume and OHCA PCI within centers was weak (R 2 = 0.10).Similarly, wide variations between operator PCI volume and OHCA PCI volume were observed. Conclusion:These national data demonstrate wide variation in the practice of OHCA PCI both between centers and individuals. These variations are not expected according to clinical factors and require further investigation.

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Factors affecting outcomes in patients with cardiac arrest who receive target temperature management: The multi-center TIMECARD registry

Cited by 12 publications

References 38 publications

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

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

Comparison between Prehospital Mechanical Cardiopulmonary Resuscitation (CPR) Devices and Manual CPR for Out-of-Hospital Cardiac Arrest: A Systematic Review, Meta-Analysis, and Trial Sequential Analysis

Variation in practice for out‐of‐hospital cardiac arrest treated with percutaneous coronary intervention in England and Wales

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