Comparison of Scores for Early Brain Damage Assessment at Intensive Care Unit Admission After Out of Hospital Cardiac Arrest

Study Overview
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Brief Summary
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Even in patients with successful return of spontaneous circulation (ROSC), outcome after cardiac arrest remains poor. The overall in-hospital survival rate widely varies both worldwide and across communities, from 1 to 4 folds according to circumstances of arrest and post-resuscitation interventions. Several studies have already shown that early interventions performed after ROSC, such as treatment of the cause, targeted temperature management, optimal hemodynamic management and extra-corporeal life support in selected patients, could improve the outcome in post-cardiac arrest patients. However, the decision process regarding the allocation of these resources, in parallel with the management of patients' proxies, remains a complex challenge for physicians facing these situations. Consequently, several prediction models and scores have been developed in order to stratify the risk of unfavorable outcome and to discriminate the best candidates for post-resuscitation interventions. Overall, several scores exist, but external validation are lacking and direct comparisons are needed to assess relative interest of scoring systems. Indeed, establishing the optimal scoring system is crucial, for optimal treatment allocation and appropriate information to relatives.

Official Title
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Comparison of Scores for Early Brain Damage Assessment at Intensive Care Unit Admission After Out of Hospital Cardiac Arrest

Conditions
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Cardiac Arrest

Intervention / Treatment
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* Diagnostic Test: Calculation of early prognosis score


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: - All adult patients, major, admitted to intensive care after out-of-hospital cardiac arrest and comatose (defined by Glasgow score ≤ 8) on admission. Exclusion Criteria: cardiac arrest occurring intra-hospital, minor patient, major patient under guardianship, protected persons, prior inclusion in the study

Ages Eligible for Study
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Minimum Age: 18 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Patients admitted in the intensive care unit<br>Patients with return of spontaneous circulation after cardiac arrest regardless of initial rhythm, and admitted in intensive care unit for post cardiac arrest care | Diagnostic Test: Calculation of early prognosis score<br>* Early prognosis score will be calculated at intensive care unit admission for each patient based on clinical and biological values as required<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Determination of Area Under Curve of Cerebral Admission Hospital Prognosis (CAHP) Score at intensive care unit admission | Determination of AUC for CAHP score as compare to Utstein style criteria. CAHP score range from 0 to 300 with higher score indicates poorer prognosis | Intensive Care Unit Admission (Usually 3 hours after cardiac arrest) | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Determination of Area Under Curve of modified CAHP Score at intensive care unit admission | Determination of AUC for modified CAHP score as compare to Utstein style criteria mCAHP score range from 0 to 280 with higher score indicates poorer prognosis | Intensive Care Unit Admission (Usually 3 hours after cardiac arrest) | 
| Determination of Area Under Curve of simplified CAHP Score at intensive care unit admission | Determination of AUC for simplified CAHP score as compare to Utstein style criteria sCAHP score range from 0 to 150 with higher score indicates poorer prognosis | Intensive Care Unit Admission (Usually 3 hours after cardiac arrest) | 
| Determination of Area Under Curve of OHCA Score at intensive care unit admission | Determination of AUC for OHCA score as compare to Utstein style criteria OHCA score range from -30 to 60 with higher score indicates poorer prognosis | Intensive Care Unit Admission (Usually 3 hours after cardiac arrest) | 
| Determination of Area Under Curve of CREST Score at intensive care unit admission | Determination of AUC for CREST score as compare to Utstein style criteria CREST score range from 0 to 5 with higher score indicates poorer prognosis | Intensive Care Unit Admission (Usually 3 hours after cardiac arrest) | 
| Determination of Area Under Curve of C-Graph Score at intensive care unit admission | Determination of AUC for C-Graph score as compare to Utstein style criteria C-Graph score range from 0 to 5 with higher score indicates poorer prognosis | Intensive Care Unit Admission | 
| Determination of Area Under Curve of TTM Score at intensive care unit admission | Determination of AUC for TTM score as compare to Utstein style criteria TTM score range from -2 to 35 with higher score indicates poorer prognosis | Intensive Care Unit Admission (Usually 3 hours after cardiac arrest) | 
| Determination of Area Under Curve of NULL-PLEASE Score at intensive care unit admission | Determination of AUC for NULL-PLEASE score as compare to Utstein style criteria NULL-PLEASE score range from 0 to 14 with higher score indicates poorer prognosis | Intensive Care Unit Admission (Usually 3 hours after cardiac arrest) | 
| Determination of calibration of each score | Determination of calibration of: CAHP, sCAHP, mCAHP, OHCA, CREST, C-Graph, TTM and NULL-PLEASE score | Intensive Care Unit Admission (Usually 3 hours after cardiac arrest) | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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cardiac arrest, hypothermia induced, intensive care unit