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External validation and insights about the calibration of the return of spontaneous circulation after cardiac arrest (RACA) score

BACKGROUND: The return of spontaneous circulation (ROSC) after cardiac arrest (RACA) score was developed as a tool to predict ROSC probability (pROSC) based on easily available information and it could be useful to compare the performances of different EMS agencies or the effects of eventual interve...

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Autores principales: Gamberini, Lorenzo, Tartivita, Chiara Natalia, Guarnera, Martina, Allegri, Davide, Baroncini, Simone, Scquizzato, Tommaso, Tartaglione, Marco, Alberto Mazzoli, Carlo, Chiarini, Valentina, Picoco, Cosimo, Coniglio, Carlo, Semeraro, Federico, Gordini, Giovanni
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Elsevier 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8983431/
https://www.ncbi.nlm.nih.gov/pubmed/35403069
http://dx.doi.org/10.1016/j.resplu.2022.100225
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author Gamberini, Lorenzo
Tartivita, Chiara Natalia
Guarnera, Martina
Allegri, Davide
Baroncini, Simone
Scquizzato, Tommaso
Tartaglione, Marco
Alberto Mazzoli, Carlo
Chiarini, Valentina
Picoco, Cosimo
Coniglio, Carlo
Semeraro, Federico
Gordini, Giovanni
author_facet Gamberini, Lorenzo
Tartivita, Chiara Natalia
Guarnera, Martina
Allegri, Davide
Baroncini, Simone
Scquizzato, Tommaso
Tartaglione, Marco
Alberto Mazzoli, Carlo
Chiarini, Valentina
Picoco, Cosimo
Coniglio, Carlo
Semeraro, Federico
Gordini, Giovanni
author_sort Gamberini, Lorenzo
collection PubMed
description BACKGROUND: The return of spontaneous circulation (ROSC) after cardiac arrest (RACA) score was developed as a tool to predict ROSC probability (pROSC) based on easily available information and it could be useful to compare the performances of different EMS agencies or the effects of eventual interventions. We performed an external validation of the RACA score in a cohort of out of hospital cardiac arrest (OHCA) patients managed by the EMS of the metropolitan city of Bologna, Italy. METHODS: We analyzed data from 2,310 OHCA events prospectively collected between January 2009 and June 2021. Discrimination was assessed with the area under the ROC curve (AUROC), while the calibration belts were used for the comparison of observed versus expected ROSC rates. The AUROCs from our cohort and other validation cohorts were compared using a studentized range test. RESULTS: The AUROC for the study population was 0.691, comparable to that described by previous validation studies. Despite an acceptable overall calibration, we found a poor calibration for asystole and low pROSC ranges in PEA and shockable rhythms. The model showed a good calibration for patients aged over 80, while no differences in performance were found when evaluating events before and after the implementation of 2015 ERC guidelines. CONCLUSIONS: Despite AUROC values being similar in different validation studies for RACA score, we suggest separating the different rhythms when assessing ROSC probability with the RACA score, especially for asystole.
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spelling pubmed-89834312022-04-07 External validation and insights about the calibration of the return of spontaneous circulation after cardiac arrest (RACA) score Gamberini, Lorenzo Tartivita, Chiara Natalia Guarnera, Martina Allegri, Davide Baroncini, Simone Scquizzato, Tommaso Tartaglione, Marco Alberto Mazzoli, Carlo Chiarini, Valentina Picoco, Cosimo Coniglio, Carlo Semeraro, Federico Gordini, Giovanni Resusc Plus Clinical Paper BACKGROUND: The return of spontaneous circulation (ROSC) after cardiac arrest (RACA) score was developed as a tool to predict ROSC probability (pROSC) based on easily available information and it could be useful to compare the performances of different EMS agencies or the effects of eventual interventions. We performed an external validation of the RACA score in a cohort of out of hospital cardiac arrest (OHCA) patients managed by the EMS of the metropolitan city of Bologna, Italy. METHODS: We analyzed data from 2,310 OHCA events prospectively collected between January 2009 and June 2021. Discrimination was assessed with the area under the ROC curve (AUROC), while the calibration belts were used for the comparison of observed versus expected ROSC rates. The AUROCs from our cohort and other validation cohorts were compared using a studentized range test. RESULTS: The AUROC for the study population was 0.691, comparable to that described by previous validation studies. Despite an acceptable overall calibration, we found a poor calibration for asystole and low pROSC ranges in PEA and shockable rhythms. The model showed a good calibration for patients aged over 80, while no differences in performance were found when evaluating events before and after the implementation of 2015 ERC guidelines. CONCLUSIONS: Despite AUROC values being similar in different validation studies for RACA score, we suggest separating the different rhythms when assessing ROSC probability with the RACA score, especially for asystole. Elsevier 2022-04-01 /pmc/articles/PMC8983431/ /pubmed/35403069 http://dx.doi.org/10.1016/j.resplu.2022.100225 Text en © 2022 The Author(s) https://creativecommons.org/licenses/by-nc-nd/4.0/This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).
spellingShingle Clinical Paper
Gamberini, Lorenzo
Tartivita, Chiara Natalia
Guarnera, Martina
Allegri, Davide
Baroncini, Simone
Scquizzato, Tommaso
Tartaglione, Marco
Alberto Mazzoli, Carlo
Chiarini, Valentina
Picoco, Cosimo
Coniglio, Carlo
Semeraro, Federico
Gordini, Giovanni
External validation and insights about the calibration of the return of spontaneous circulation after cardiac arrest (RACA) score
title External validation and insights about the calibration of the return of spontaneous circulation after cardiac arrest (RACA) score
title_full External validation and insights about the calibration of the return of spontaneous circulation after cardiac arrest (RACA) score
title_fullStr External validation and insights about the calibration of the return of spontaneous circulation after cardiac arrest (RACA) score
title_full_unstemmed External validation and insights about the calibration of the return of spontaneous circulation after cardiac arrest (RACA) score
title_short External validation and insights about the calibration of the return of spontaneous circulation after cardiac arrest (RACA) score
title_sort external validation and insights about the calibration of the return of spontaneous circulation after cardiac arrest (raca) score
topic Clinical Paper
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8983431/
https://www.ncbi.nlm.nih.gov/pubmed/35403069
http://dx.doi.org/10.1016/j.resplu.2022.100225
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