Application of prognostic score to patients following cardiac arrest

Introduction

The use of prognostic scores in continuous form may help in decision-making in the post-resuscitation phase following cardiac arrest.

Objective

To evaluate the clinical efficacy of a prognostic score [1] on intrahospital mortality of patients suffering extrahospital cardiac arrest.

Material and method

A 6 month prospective study carried out on 37 patients in the Emergency Unit of a 650 bed hospital (attending to a total of 74 000 patients per year). A score of 0-6 based on cardiac rhythm at time of arrest was applied (cardiac rhythm different to ventricular tachicardia without pulse or vcntricular fibrillation = 3). Glasgow score at the time of admission (4 or 5 = 1 and 3 = 2) and type of cardiopulmonary resuscitation received up to arrival of Emergency Assistance (no first aid from qualified personnel at time of arrest = 1).

Results

Average age was 61.8 ± 14.9 years (29-84), with sex distribution of 59.4% male and 40.5% female.

Conclusion

1 The application of this score may prove useful in clinical practice to evaluate the continuity of life-support. 2 Neurological assessment is the most valuable clinical variable for prognosis in the follow-up phase. 3 As in other studies, age is not a determining factor in intrahospital mortality following cardiac arrest. 4 Median arterial pressure shows a difference of some 20 points between the surviving and non surviving groups. 5 Mortality among males is significantily greater than females after receiving CPR. 6 The type of assistance received prior to arrival of health services is of significant value in the survival chain.

Table 1