Martens P R, Mullie A, Buylaert W, Calle P, van Hoeyweghen R
Department of Anaesthesia and Critical Care, A.Z. St. Jan Hospital, Brugge, Belgium.
Intensive Care Med. 1992;18(1):11-4. doi: 10.1007/BF01706419.
A total of 6178 persons with out-of-hospital (70%) and in hospital (30%) cardiac arrests from the first of January 1982 until the end of 1989 were reviewed retrospectively with respect to 4 variables, contributing to a score for specific prediction of poor prognosis (cut-off point: greater than 3 points). These included age, initial ECG, type of respiratory arrest and bystander resuscitation. Presence of ventricular fibrillation, gasping and bystander resuscitation contributes nothing to the score, while presence of asystole or EMD (electromechanical dissociation), apnoea and absence of bystander resuscitation adds one point to it. Of patients scoring 4 or 5 points 44 were awake 14 days post CPR (Class 3). The positive predictive value of the score was 97% (95% CI 96-98%) for the out-of-hospital group and 92.2% (95% CI 88-95%) for the in-hospital group. The specificity was respectively 92.3% (95% CI 89-95%) and 94.2% (95% CI 91-96%). Although the score can weigh the likelihood of no success against that of success, we cannot recommend it for decision making as far as abandoning or continuing cardiopulmonary resuscitation efforts.
回顾性分析了1982年1月1日至1989年底共6178例院外（70%）和院内（30%）心脏骤停患者的4个变量，以得出一个用于特定预测不良预后的评分（临界值：大于3分）。这些变量包括年龄、初始心电图、呼吸骤停类型和旁观者心肺复苏情况。室颤、喘息样呼吸和旁观者心肺复苏对评分无影响，而心脏停搏或电机械分离、呼吸暂停以及无旁观者心肺复苏则各加1分。得分为4分或5分的患者中，44例在心肺复苏后14天仍未苏醒（3级）。该评分对院外组的阳性预测值为97%（95%置信区间96 - 98%），对院内组为92.2%（95%置信区间88 - 95%）。特异性分别为92.3%（95%置信区间89 - 95%）和94.2%（95%置信区间91 - 96%）。尽管该评分可以权衡复苏失败与成功的可能性，但就放弃或继续心肺复苏努力的决策而言，我们不建议使用它。
