Cardiac Arrest Survival Score (CRASS)

Study Overview
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Brief Summary
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Survival following cardiopulmonary resuscitation (CPR) from out-of-hospital cardiac arrest (OHCA) depends on numerous prehospital and in-hospital variables and interventions. The aim of this study was to develop a score to predict the resuscitation outcome after OHCA at hospital discharge. All patients suffered OHCA between 01.01.2010 and 31.12.2016 with ROSC or ongoing CPR at hospital admission in Emergency Medical Service (EMS) systems with good quality in documentation in the German Resuscitation Registry (GRR) were included. The study population was divided into development dataset (5,775) and validation dataset (1,457) by random. Binary logistic regression analysis was used to derive the score. Hospital discharge with good neurological function (CPC 1-2 or mRS 0-2) was used as dependent variable, and various combination of potential predictor variables were used to create the model.

Detailed Description
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This study is a retrospective analysis of 8,603 prospectively documented OHCA patients between 01.01.2010 and 31.12.2016 within the German Resuscitation Registry (GRR),4 attended by EMS. The GRR represents currently approximately 160 emergency medical systems who record data on out-of-hospital resuscitation attempts throughout Germany, thus encompassing approximately 30 million citizens (total population of Germany counts 85 million). The German Resuscitation Registry for out-of-hospital cardiac arrest is divided into two different datasets: The 'Preclinical care' dataset originated from the Utstein-style template aiming at documentation of pre-hospital logistic issues, presumed aetiology, resuscitation therapy and patient's initial outcome including 118 variables.12 The 'Postresuscitation care' dataset is aimed at documentation of in-hospital post-resuscitation efforts. The participating hospitals can choose between a basic version which includes the use of coronary angiography, temperature management and the status at hospital discharged and an extended version. This includes 156 variables and inquires especially the status at admission, initial blood gas analysis, temperature management, coronary angiography and survival at 24h after cardiac arrest, 30 days and at hospital discharge exactly.12 Participation in the registry is voluntary. The participating emergency medical services and hospitals submit their data anonymously into a central database via a web-based application. Multiple plausibility checks have been implemented into this application in order to improve data quality. The registry is organised and funded by the German Society of Anaesthesiology and Intensive Care Medicine (DGAI).

Official Title
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Cardiac Arrest Survival Score (CRASS) - a Tool to Predict Good Neurological Outcome After Out of Hospital Cardiac Arrest

Conditions
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Cardiac Arrest

Intervention / Treatment
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* Other: Survival / not survival


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: OHCA between 01.01.2010 and 31.12.2016 ROSC or ongoing CPR on hopsital admission high quality documentation with more than 75% documentation of post resuscitation care in hospital Patients cases documented in German Resuscitation Registry Between 01.01.2010 and 31.12.2016 the 'Preclinical care' dataset contained 8,603 out-of-hospital CA patients with return of spontaneous circulation (ROSC) or ongoing CPR at hospital admission in EMS systems with good documentation quality. Good quality of documentation was defined by documented post-resuscitation care in more than 75%. Exclusion Criteria: incomplete dataset age less than 18 years unknown initial ECG unknown age unknown neurological status on hospital discharge 1,371 patients were excluded from further analysis because of incomplete data in terms of age, neurological status at hospital discharge, unknown initial EKG or age < 18 years.

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 |
| --- | --- |
| Development<br>The study population was divided into two parts by random: development dataset (5,775) and validation dataset (1,457) | Other: Survival / not survival<br>* Outcome with good neurological status vs. bad neurological status at hospital discharge<br>|
| Validation<br>The study population was divided into two parts by random: development dataset (5,775) and validation dataset (1,457) | Other: Survival / not survival<br>* Outcome with good neurological status vs. bad neurological status at hospital discharge<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| good neurological outcome | CPC 1 and 2 or mRS 0-2 | 30 days after OHCA | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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cardiac arrest, OHCA survival score, predicting survival, German Resuscitation Registry