Can the Clinical Frailty Scale predict futility in out-of-hospital cardiac arrest?

Abstract

Background: Cardiopulmonary resuscitation (CPR) is considered an essential intervention in unanticipated cardiac arrest, but in the out-of-hospital setting it is often the default treatment for many patients dying of chronic and incurable disease who experience this. The Clinical Frailty Scale (CFS) can predict an individual's vulnerability to adverse health outcomes and might be a useful tool in prognostication in the prehospital setting. Aims: The primary aim was to assess if the CFS can be used for prognostication in cardiac arrest and whether UK paramedics would be able to use the CFS in the context of an out-of-hospital cardiac arrest. Methods: A rapid review of the literature was undertaken to identify research relating to frailty's influence on cardiac arrest outcomes. Five primary research articles were identified and were included. Findings: All the primary research focused on in-hospital cardiac arrest and demonstrated that an higher clinical frailty score was associated with increased mortality following cardiac arrest, with a significant reduction in survival at CFS ≥6. Conclusion: Research could assess whether these findings would be replicated in the out-of-hospital cardiac arrest context and whether paramedics could use the CFS to aid in prognostication in this situation.