Abstract 295: Predicting Outcomes in Adult Patients With Out-of-Hospital Cardiac Arrest; Results From the All-Japan Utstein Registry

Abstract

Background: The recent cardiopulmonary resuscitation (CPR) Guideline addressed that there was no evidence to clearly define what should constitute selected patients in case of performing invasive CPR, such as extracorporeal CPR, for patients with cardiac arrest (CA). However, emergency physicians often need to determine the treatment strategy immediately upon arrival in emergency departments. The present study aimed to clarify the helpful factor of prehospital care to predict adult CA patients' prognosis using the All-Japan Utstein Registry data, a prospective, nationwide, population-based registry of out-of-hospital CA (OHCA). Methods: From the data of this registry, between 2005 and 2020, we included adult OHCA patients due to cardiac etiology. The endpoint was the favorable neurological outcome at 30 days after OHCA. The multivariable logistic regression analysis included potential confounding factors based on biological plausibility and previous studies. We scored based on the odds ratio. Receiver operating characteristic analysis was performed, and the area under the curve (AUC) was calculated for factors of the total score in order to assess the 30-day neurological outcome. Results: Of the 1,930,273 patients registered in this Registry, the data of 1,099,908 patients were included in this analysis. The table showed the adjusted odds ratio for 30-day favorable neurological outcomes in OHCA patients in the multivariate analysis, and the score based on the odds ratio. The AUC of the total scores was 0.956 (p < 0.001) with a cutoff value of 7, a sensitivity of 92%, and a specificity of 88%. In the case of this total score of less than 7, the 30-day favorable neurological outcome in CA patients was significantly low (total score < 7 vs. total score > 7 = 0.3% vs. 18.7%: p<0.001). Conclusion: This score might be a helpful factor in prehospital care information in CA patients to determine the treatment strategy upon arrival in emergency departments.