Background: Out-of-hospital cardiac arrest (OHCA) remains a major clinical challenge with high morbidity and mortality. The cardiac arrest hospital prognosis (CAHP) score is a validated tool for predicting neurological and survival outcomes in patients achieving return of spontaneous circulation (ROSC). This study aimed to validate the prognostic performance of the CAHP score in a cohort of OHCA patients in Qatar, with a focus on survival, neurological outcomes, and the impact of bystander-initiated cardiopulmonary resuscitation (CPR). Methods: We conducted a retrospective cohort study of adult OHCA patients admitted alive to Hamad Medical Corporation, Qatar, between June 2022 and October 2023. Patients without ROSC were excluded, as CAHP scoring requires survival to admission. Data included demographics, clinical history, coronary findings, and CAHP scores (documented vs. auditor-calculated). Outcomes assessed were 30-day survival and neurological status. Statistical tests included Chi-square and Pearson correlation. Results: Ninety-two patients were included (mean age 51 ± 12.6 years, 91.3% male). Cardiac etiology was identified in 64.1% (59/92), with ST-elevation myocardial infarction (STEMI) present in 97% of these cases. Thirty-day survival was 71.7% overall and 73.7% among STEMI patients; however, 33.7% of survivors exhibited hypoxic brain injury. Auditor-calculated CAHP scores differed significantly from documented values ( P < 0.001). Low-risk patients (CAHP < 150) demonstrated the best survival with good neurological outcomes (93.6%), compared to 57.5% in intermediate and 10.5% in high-risk groups. Bystander CPR, reported separately from the CAHP score, was performed in 66.3% of cases and was positively associated with 30-day survival ( R = 0.217, P = 0.038). Conclusion: The CAHP score is a reliable predictor of survival and neurological outcomes in OHCA patients admitted alive in Qatar. Accurate score calculation is essential, as documentation may underestimate patient risk. Bystander CPR remains a critical determinant of survival, highlighting the importance of community CPR training. These findings support integrating CAHP-based stratification into local OHCA management guidelines.
Ashour et al. (Wed,) studied this question.