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

Area of Science:

• Critical Care Medicine
• Neurology
• Cardiology

Background:

• Predicting neurological prognosis in in-hospital cardiac arrest (IHCA) patients post-ROSC is crucial for guiding critical management decisions.
• Timely and accurate prognostication aids in optimizing patient care and resource allocation.

Purpose of the Study:

• To evaluate the predictive utility of the Cardiac Arrest Survival Post-Resuscitation In-hospital (CASPRI) and Good Outcome Following Attempted Resuscitation (GO-FAR) scores for neurological outcomes in IHCA patients immediately after ROSC.
• To compare the effectiveness of CASPRI and GO-FAR scores in identifying patients with good neurological prognoses.

Main Methods:

• Retrospective analysis of 488 adult IHCA patients who achieved sustained ROSC between September 2016 and August 2021.
• Comparison of CASPRI and GO-FAR scores against Cerebral Performance Category (CPC) scores at discharge (CPC 1-2 defined as good outcome).
• Receiver operating characteristic (ROC) curve analysis was used to assess the predictive performance of each score.

Main Results:

• 85 (20.8%) patients had a good neurological outcome (CPC score 1-2) at discharge.
• The CASPRI score demonstrated a higher area under the ROC curve (0.75) for predicting good neurological outcomes compared to the GO-FAR score (0.67).
• These findings suggest CASPRI has superior predictive accuracy for neurological prognosis post-IHCA.

Conclusions:

• Both CASPRI and GO-FAR scores can aid in predicting neurological prognoses for IHCA patients after ROSC.
• The CASPRI score appears to be a more effective tool for timely and satisfactory prediction of neurological outcomes in this patient population.
• Further validation of these scores can enhance clinical decision-making in post-cardiac arrest care.