Cardiac Arrest Clinical Trial
Official title:
Cardiac Arrest Survival Score (CRASS) - a Tool to Predict Good Neurological Outcome After Out of Hospital Cardiac Arrest
Survival following cardiopulmonary resuscitation (CPR) from out-of-hospital cardiac arrest
(OHCA) depends on numerous prehospital and in-hospital variables and interventions. The aim
of this study was to develop a score to predict the resuscitation outcome after OHCA at
hospital discharge.
All patients suffered OHCA between 01.01.2010 and 31.12.2016 with ROSC or ongoing CPR at
hospital admission in Emergency Medical Service (EMS) systems with good quality in
documentation in the German Resuscitation Registry (GRR) were included. The study population
was divided into development dataset (5,775) and validation dataset (1,457) by random. Binary
logistic regression analysis was used to derive the score. Hospital discharge with good
neurological function (CPC 1-2 or mRS 0-2) was used as dependent variable, and various
combination of potential predictor variables were used to create the model.
This study is a retrospective analysis of 8,603 prospectively documented OHCA patients
between 01.01.2010 and 31.12.2016 within the German Resuscitation Registry (GRR),4 attended
by EMS. The GRR represents currently approximately 160 emergency medical systems who record
data on out-of-hospital resuscitation attempts throughout Germany, thus encompassing
approximately 30 million citizens (total population of Germany counts 85 million).
The German Resuscitation Registry for out-of-hospital cardiac arrest is divided into two
different datasets:
1. The 'Preclinical care' dataset originated from the Utstein-style template aiming at
documentation of pre-hospital logistic issues, presumed aetiology, resuscitation therapy
and patient's initial outcome including 118 variables.12
2. The 'Postresuscitation care' dataset is aimed at documentation of in-hospital
post-resuscitation efforts. The participating hospitals can choose between a basic
version which includes the use of coronary angiography, temperature management and the
status at hospital discharged and an extended version. This includes 156 variables and
inquires especially the status at admission, initial blood gas analysis, temperature
management, coronary angiography and survival at 24h after cardiac arrest, 30 days and
at hospital discharge exactly.12 Participation in the registry is voluntary. The
participating emergency medical services and hospitals submit their data anonymously
into a central database via a web-based application. Multiple plausibility checks have
been implemented into this application in order to improve data quality. The registry is
organised and funded by the German Society of Anaesthesiology and Intensive Care
Medicine (DGAI).
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