1st Department of Cardiology, Medical University of Warsaw, Banacha 1a, 02-097 Warsaw, Poland.
Department of Cardiology Medical University of Silesia SMDZ, Silesian Center for Heart Diseases, Zabrze, Poland.
Cardiol J. 2021;28(1):95-100. doi: 10.5603/CJ.a2019.0035. Epub 2019 Apr 17.
Prompt reperfusion and post-resuscitation care, including targeted temperature management (TTM), improve survival in out-of-hospital cardiac arrest (OHCA) patients. To predict inhospital mortality in OHCA patients treated with TTM, the Polish Hypothermia Registry Risk Score (PHR-RS) was developed. The use of dedicated risk stratification tools may support treatment decisions.
Three hundred seventy-six OHCA patients who underwent TTM between 2012 and 2016 were retrospectively analysed and whose data were collected in the Polish Hypothermia Registry. A multivariate logistic regression model identified a set of predictors of in-hospital mortality that were used to develop a dedicated risk prediction model, which was tested for accuracy.
The mean age of the studied population was 59.2 ± 12.9 years. 80% of patients were male, 73.8% had shockable rhythms, and mean time from cardiac arrest (CA) to cardiopulmonary resuscitation (CPR) was 7.2 ± 8.6 min. The inputs for PHR-RS were patient age and score according to the Mild Therapeutic Hypothermia (MTH) Scale. Criteria for the MTH score consisted of time from CA to CPR above 10 min, time from CA to the return of spontaneous circulation above 20 min, in-hospital CA, unwitnessed CA, and non-shockable rhythm, each counted as 1 point. The predictive value of PHR-RS was expressed as an area under the curve of 0.74.
PHR-RS is one of the simplest and easiest models to use and enables a reliable prediction of in-hospital mortality in OHCA patients treated with TTM.
及时复灌和复苏后治疗，包括目标温度管理（TTM），可提高院外心脏骤停（OHCA）患者的存活率。为了预测接受 TTM 治疗的 OHCA 患者的院内死亡率，开发了波兰低温治疗登记风险评分（PHR-RS）。使用专门的风险分层工具可能有助于治疗决策。
回顾性分析了 2012 年至 2016 年间接受 TTM 治疗的 376 例 OHCA 患者，并在波兰低温治疗登记处收集了这些患者的数据。多变量逻辑回归模型确定了一组与院内死亡率相关的预测因子，这些预测因子被用于开发专门的风险预测模型，并对其准确性进行了测试。
研究人群的平均年龄为 59.2±12.9 岁。80%的患者为男性，73.8%为可除颤节律，心脏骤停（CA）至心肺复苏（CPR）的平均时间为 7.2±8.6 分钟。PHR-RS 的输入为患者年龄和根据轻度治疗性低温（MTH）量表的评分。MTH 评分标准包括 CA 至 CPR 时间超过 10 分钟、CA 至自主循环恢复时间超过 20 分钟、院内 CA、无人见证的 CA 和非可除颤节律，每个标准计 1 分。PHR-RS 的预测价值表示为曲线下面积为 0.74。
PHR-RS 是最简单和最容易使用的模型之一，能够可靠地预测接受 TTM 治疗的 OHCA 患者的院内死亡率。
