Background Survival with good neurological function post out-of-hospital cardiac arrest (OHCA), defined as cerebral performance category (CPC) 1–2, ranges from 1.6% to 3% in Asia. We aim to study the influence of comorbidities and peri-OHCA event factors on neurological recovery and develop a model that can help clinicians predict neurological function among patients with post-OHCA admitted to the hospital.
Methods This was a retrospective cohort study. All patients admitted post-OHCA from 1 January 2011 to 31 December 2015 to a tertiary centre were identified through the hospital OHCA registry. Patients who survived till hospital admission were included. Logistic regression was used to identify patient and peri-arrest factors that were significantly associated with survival with CPC 1–2. The significant factors for survival with CPC 1–2 were then put into a multivariable model and the discriminative ability was tested using the receiver operator characteristic (ROC) curve. Calibration and internal validation of the model were also performed. External validation in a small prospective cohort was also performed.
Results In our derivation cohort of 129 patients, 30.23% survived with CPC 1–2. Significant factors associated with survival with good neurological outcomes were age-adjusted Charlson Comorbidity Index ≤5, time to first return of spontaneous circulation ≤40 min, the presence of immediate bystander cardiopulmonary resuscitation and shockable rhythms. We also developed a nomogram which showed good internal (ROC curve 0.84; 95% CI 0.77 to 0.91) and external validation (ROC curve 0.90; 95% CI 0.81 to 1.00).
- sudden cardiac death
- ventricular fibrillation
- emergency medicine
- risk stratification
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Contributors All authors have participated in the work and have reviewed and agree with the content of the article.
Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.
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Competing interests None declared.
Patient consent Not required.
Ethics approval Singhealth Centralised Institutional Review Board.
Provenance and peer review Not commissioned; externally peer reviewed.
Data sharing statement Statistical code and raw data set can be made available upon request via contacting the corresponding author.
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