Validation of the Good Outcome Following Attempted Resuscitation (GO-FAR) score in an East Asian population

Abstract

AimThe Good Outcome Following Attempted Resuscitation (GO-FAR) score is useful for identifying patients post-arrest with very poor neurologic outcomes and may thus be utilized when counseling family members on do-not-attempt-resuscitation (DNAR) order. We validated the GO-FAR score for neurologically intact survival in patients with in-hospital cardiac arrest (IHCA) in an East Asian country in which DNAR order not common. MethodsRetrospective study about patients who experienced IHCA from 2013 to 2017 with a primary outcome of neurologically intact survival, defined as a CPC score 1 or 2 at discharge. GO-FAR score categorizes the patients into 4 groups: a very low (<1%), low (1%–3%), average (>3%–15%), or higher than average (>15%) likelihood of neurologically intact survival. ResultsOf the 1011 included patients, the rates of survival discharge and neurologically intact survival at discharge were 25.4% and 16.0%, respectively. The area under the receiver operating characteristics curve of GO-FAR score for good neurological outcome was 0.81 (95% CI, 0.78–0.84). Patients with low or very low probability of survival had a likelihood of 0.9% (95% CI, 0.0–2.0), but for those under 40 years old, it was increased to 4.2% (95% CI, 0.0–12.2). Patients with average or above-average probabilities had likelihoods of of 18.5% (95% CI, 15.3–21.6) and 50.5% (95% CI, 40.6–60.5), respectively. ConclusionsThe GO-FAR score well-predicted the neurologically intact survival of East Asian patients with IHCA. This tool may be used as part of a shared decision regarding DNAR orders.