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. 2015 Apr:89:86-92.
doi: 10.1016/j.resuscitation.2015.01.020. Epub 2015 Jan 28.

Validation of the Pittsburgh Cardiac Arrest Category illness severity score

Patrick J Coppler  1 , Jonathan Elmer  2 , Luis Calderon  3 , Alexa Sabedra  3 , Ankur A Doshi  3 , Clifton W Callaway  4 , Jon C Rittenberger  3 , Cameron Dezfulian  5 ; Post Cardiac Arrest Service
Collaborators, Affiliations

Validation of the Pittsburgh Cardiac Arrest Category illness severity score

Patrick J Coppler et al. Resuscitation. 2015 Apr.

Abstract

Background: The purpose of this study was to validate the ability of an early post-cardiac arrest illness severity classification to predict patient outcomes.

Methods: The Pittsburgh Cardiac Arrest Category (PCAC) is a 4-level illness severity score that was found to be strongly predictive of outcomes in the initial derivation study. We assigned PCAC scores to consecutive in and out-of-hospital cardiac arrest subjects treated at two tertiary care centers between January 2011 and September 2013. We made assignments prospectively at Site 1 and retrospectively at Site 2. Our primary outcome was survival to hospital discharge. Inter-rater reliability of retrospective PCAC assessments was assessed. Secondary outcomes were favorable discharge disposition (home or acute rehabilitation), Cerebral Performance Category (CPC) and modified Rankin Scale (mRS) at hospital discharge. We tested the association of PCAC with each outcome using unadjusted and multivariable logistic regression.

Results: We included 607 cardiac arrest patients during the study (393 at Site 1 and 214 at Site 2). Site populations differed in age, arrest location, rhythm, use of hypothermia and distribution of PCAC. Inter-rater reliability of retrospective PCAC assignments was excellent (κ=0.81). PCAC was associated with survival (unadjusted odds ratio (OR) for Site 1: 0.33 (95% confidence interval (CI) 0.27-0.41)) Site 2: 0.32 (95% CI 0.24-0.43) even after adjustment for other clinical variables (adjusted OR Site 1: 0.32 (95% CI 0.25-0.41) Site 2: 0.31 (95% CI 0.22-0.44)). PCAC was predictive of secondary outcomes.

Conclusions: Our results confirm that PCAC is strongly predictive of survival and good functional outcome after cardiac arrest.

Keywords: Critical care medicine; Epidemiology; Outcome; Resuscitation.

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Conflict of interest statement

Conflicts of interest: None

Figures

Figure 1
Figure 1
Distribution of PCAC and survival by hospital site.
See this image and copyright information in PMC

References

    1. Roger VL, Go AS, Lloyd-Jones DM, et al. Heart disease and stroke statistics--2012 update: a report from the American Heart Association. Circulation. 2012;125(1):e2–e220. - PMC - PubMed
    1. Adrie C, Cariou A, Mourvillier B, et al. Predicting survival with good neurological recovery at hospital admission after successful resuscitation of out-of-hospital cardiac arrest: the OHCA score. Eur Heart J. 2006;27(23):2840–2845. - PubMed
    1. Chan PS, Spertus JA, Krumholz HM, et al. A validated prediction tool for initial survivors of in-hospital cardiac arrest. Archives of internal medicine. 2012;172(12):947–953. - PMC - PubMed
    1. Ebell MH, Jang W, Shen Y, Geocadin RG Get With the Guidelines-Resuscitation I. Development and validation of the Good Outcome Following Attempted Resuscitation (GO-FAR) score to predict neurologically intact survival after in-hospital cardiopulmonary resuscitation. JAMA internal medicine. 2013;173(20):1872–1878. - PubMed
    1. Rittenberger JC, Tisherman SA, Holm MB, Guyette FX, Callaway CW. An early, novel illness severity score to predict outcome after cardiac arrest. Resuscitation. 2011;82(11):1399–1404. - PMC - PubMed

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