Usefulness of a simple prognostication score in prediction of the prognoses of patients with out-of-hospital cardiac arrests.

Sudden cardiac death is a serious problem in public health but the overall survival rate of out-of-hospital cardiac arrests (OHCAs) remains low. In this study, we identified clinical parameters to predict the prognosis of OHCA patients and proposed a simple prognostication score for prediction of their prognoses. The study population consisted of 750 consecutive patients with OHCAs of internal cause who were transported to our institute from July 2008 to June 2010. They were divided into survivors and nonsurvivors, and clinical parameters were compared between them to detect significant parameters for prediction of their prognoses. The population of those who survived at 1 month numbered 34. Multivariate analysis exhibited 10 independent predictive factors of survival, which included witnessed cardiac arrest and bystander-initiated CPR. When the prognostication score was calculated from these independent predictive factors, a score of ≥ 6 points indicated survival with a sensitivity of 88.6% and a specificity of 97.6%. When the patients were divided into younger and older populations with a threshold of 70 years, these values were 94.1% and 96.1% in younger but 70.0% and 98.4% in older patients, respectively. In retrospective observation, a simple prognostication score was useful to predict patient prognoses in OHCAs, but its usefulness was limited in an older population.