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Prognostic value of OHCA, C-GRApH and CAHP scores with initial neurologic examinations to predict neurologic outcomes in cardiac arrest patients treated with targeted temperature management

OBJECTIVE: The aim of this study in out-of-hospital cardiac arrest (OHCA) patients treated with targeted temperature management (TTM) was to evaluate the prognostic value of OHCA, C-GRApH, and CAHP scores with initial neurologic examinations for predicting neurologic outcomes. METHODS: This retrospe...

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Detalles Bibliográficos
Autores principales: Kim, Hyun Soo, Park, Kyu Nam, Kim, Soo Hyun, Lee, Byung Kook, Oh, Sang Hoon, Jeung, Kyung Woon, Choi, Seung Pill, Youn, Chun Song
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Public Library of Science 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7182181/
https://www.ncbi.nlm.nih.gov/pubmed/32330180
http://dx.doi.org/10.1371/journal.pone.0232227
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author Kim, Hyun Soo
Park, Kyu Nam
Kim, Soo Hyun
Lee, Byung Kook
Oh, Sang Hoon
Jeung, Kyung Woon
Choi, Seung Pill
Youn, Chun Song
author_facet Kim, Hyun Soo
Park, Kyu Nam
Kim, Soo Hyun
Lee, Byung Kook
Oh, Sang Hoon
Jeung, Kyung Woon
Choi, Seung Pill
Youn, Chun Song
author_sort Kim, Hyun Soo
collection PubMed
description OBJECTIVE: The aim of this study in out-of-hospital cardiac arrest (OHCA) patients treated with targeted temperature management (TTM) was to evaluate the prognostic value of OHCA, C-GRApH, and CAHP scores with initial neurologic examinations for predicting neurologic outcomes. METHODS: This retrospective study included OHCA patients treated with TTM from 2009 to 2017. We calculated three cardiac arrest (CA)-specific risk scores (OHCA, C-GRApH, and CAHP) at the time of admission. The initial neurologic examination included an evaluation of the Full Outline of UnResponsiveness brainstem reflexes (FOUR_B) and Glasgow Coma Scale motor (GCS_M) scores. The primary outcome was the neurologic outcome at hospital discharge. RESULTS: Of 311 subjects, 99 (31.8%) had a good neurologic outcome at hospital discharge. The OHCA score had an area under the receiver operating characteristic curve (AUROC) of 0.844 (95% confidence interval (CI): 0.798–0.884), the C-GRApH score had an AUROC of 0.779 (95% CI: 0.728–0.824), and the CAHP score had an AUROC of 0.872 (95% CI: 0.830–0.907). The addition of the FOUR_B or GCS_M score to the OHCA score improved the prediction of poor neurologic outcome (with FOUR_B: AUROC = 0.899, p = 0.001; with GCS_M: AUROC = 0.880, p = 0.004). The results were similar with the C-GRApH and CAHP scores in predicting poor neurologic outcome. CONCLUSIONS: This study confirms the good prognostic performance of CA-specific scores to predict neurologic outcomes in OHCA patients treated with TTM. By adding new variables associated with the initial neurologic examinations, the prognoses of neurologic outcomes improved compared to the existing scoring models.
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spelling pubmed-71821812020-05-05 Prognostic value of OHCA, C-GRApH and CAHP scores with initial neurologic examinations to predict neurologic outcomes in cardiac arrest patients treated with targeted temperature management Kim, Hyun Soo Park, Kyu Nam Kim, Soo Hyun Lee, Byung Kook Oh, Sang Hoon Jeung, Kyung Woon Choi, Seung Pill Youn, Chun Song PLoS One Research Article OBJECTIVE: The aim of this study in out-of-hospital cardiac arrest (OHCA) patients treated with targeted temperature management (TTM) was to evaluate the prognostic value of OHCA, C-GRApH, and CAHP scores with initial neurologic examinations for predicting neurologic outcomes. METHODS: This retrospective study included OHCA patients treated with TTM from 2009 to 2017. We calculated three cardiac arrest (CA)-specific risk scores (OHCA, C-GRApH, and CAHP) at the time of admission. The initial neurologic examination included an evaluation of the Full Outline of UnResponsiveness brainstem reflexes (FOUR_B) and Glasgow Coma Scale motor (GCS_M) scores. The primary outcome was the neurologic outcome at hospital discharge. RESULTS: Of 311 subjects, 99 (31.8%) had a good neurologic outcome at hospital discharge. The OHCA score had an area under the receiver operating characteristic curve (AUROC) of 0.844 (95% confidence interval (CI): 0.798–0.884), the C-GRApH score had an AUROC of 0.779 (95% CI: 0.728–0.824), and the CAHP score had an AUROC of 0.872 (95% CI: 0.830–0.907). The addition of the FOUR_B or GCS_M score to the OHCA score improved the prediction of poor neurologic outcome (with FOUR_B: AUROC = 0.899, p = 0.001; with GCS_M: AUROC = 0.880, p = 0.004). The results were similar with the C-GRApH and CAHP scores in predicting poor neurologic outcome. CONCLUSIONS: This study confirms the good prognostic performance of CA-specific scores to predict neurologic outcomes in OHCA patients treated with TTM. By adding new variables associated with the initial neurologic examinations, the prognoses of neurologic outcomes improved compared to the existing scoring models. Public Library of Science 2020-04-24 /pmc/articles/PMC7182181/ /pubmed/32330180 http://dx.doi.org/10.1371/journal.pone.0232227 Text en © 2020 Kim et al http://creativecommons.org/licenses/by/4.0/ This is an open access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/) , which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
spellingShingle Research Article
Kim, Hyun Soo
Park, Kyu Nam
Kim, Soo Hyun
Lee, Byung Kook
Oh, Sang Hoon
Jeung, Kyung Woon
Choi, Seung Pill
Youn, Chun Song
Prognostic value of OHCA, C-GRApH and CAHP scores with initial neurologic examinations to predict neurologic outcomes in cardiac arrest patients treated with targeted temperature management
title Prognostic value of OHCA, C-GRApH and CAHP scores with initial neurologic examinations to predict neurologic outcomes in cardiac arrest patients treated with targeted temperature management
title_full Prognostic value of OHCA, C-GRApH and CAHP scores with initial neurologic examinations to predict neurologic outcomes in cardiac arrest patients treated with targeted temperature management
title_fullStr Prognostic value of OHCA, C-GRApH and CAHP scores with initial neurologic examinations to predict neurologic outcomes in cardiac arrest patients treated with targeted temperature management
title_full_unstemmed Prognostic value of OHCA, C-GRApH and CAHP scores with initial neurologic examinations to predict neurologic outcomes in cardiac arrest patients treated with targeted temperature management
title_short Prognostic value of OHCA, C-GRApH and CAHP scores with initial neurologic examinations to predict neurologic outcomes in cardiac arrest patients treated with targeted temperature management
title_sort prognostic value of ohca, c-graph and cahp scores with initial neurologic examinations to predict neurologic outcomes in cardiac arrest patients treated with targeted temperature management
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7182181/
https://www.ncbi.nlm.nih.gov/pubmed/32330180
http://dx.doi.org/10.1371/journal.pone.0232227
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