Key result
The CASPRI score predicted good neurological outcomes at discharge with an area under the curve of 0.748 (OR 0.86), outperforming the GO-FAR score (AUC 0.668) in patients with in-hospital cardiac arrest.
Why the study?
The study aimed to confirm the usefulness of the CASPRI and GO-FAR scores for predicting neurological prognoses in IHCA patients immediately after ROSC.
Does the CASPRI score improve the prediction of neurological prognoses compared to the GO-FAR score in adult patients who recovered spontaneous circulation after in-hospital cardiac arrest?
Cohort (n=488)
No
Does the CASPRI score improve the prediction of neurological prognoses compared to the GO-FAR score in adult patients who recovered spontaneous circulation after in-hospital cardiac arrest?
Odds Ratio: 0.86 (95% CI 0.82–0.9)
The CASPRI score demonstrated significantly higher predictive power than the GO-FAR score for determining good neurological outcomes at discharge in patients who achieved ROSC after in-hospital cardiac arrest.
CASPRI may outperform GO-FAR for neurological prognostication after IHCA; hypothesis-generating and requires prospective validation before practice change.
Background The Cardiac Arrest Survival Post-Resuscitation In-hospital (CASPRI) and Good Outcome Following Attempted Resuscitation (GO-FAR) scores are used for predicting the outcomes of cardiac arrest. The CASPRI score was developed for the prediction of neurological outcomes after in-hospital cardiac arrest (IHCA), whereas the GO-FAR score is used to predict survival after cardiac arrest. The aim of this study was to confirm the usefulness of the CASPRI and GOFAR scores for predicting the neurological prognoses in-hospital cardiac arrest (IHCA) patients immediately after the return of spontaneous circulation (ROSC). Methods This was a retrospective analysis of patient data from a tertiary general hospital. A total of 488 adult patients who had IHCA and achieved sustained ROSC from September 2016 to August 2021 were analyzed to compare effectiveness of the CASPRI and GO-FAR scores related to neurologic prognoses. The primary outcome was Cerebral Performance Category (CPC) score at discharge. Results Of the 488 included patients, 85 (20.8%) were discharged with good prognoses (CPC score 1 or 2). The area under the receiver operating characteristic curve of CASPRI score for the prediction of a good neurological outcome was 0.748 (OR, 0.86; 95% CI, 0.82-0.90), whereas that of GO-FAR score was 0.668 (OR, 0.95; 95% CI, 0.93-0.97). Conclusion The CASPRI and GO-FAR scores include factors related to a patient's clinical condition and situations when CPR occurred. These scoring systems can be used for timely and satisfactory prediction of the neurological prognoses of IHCA patients after ROSC.
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Jung et al. (2022) conducted a cohort in In-hospital cardiac arrest (IHCA) (n=488). CASPRI score vs. GO-FAR score was evaluated on Cerebral Performance Category (CPC) score at discharge (good prognosis = CPC 1 or 2) (OR 0.86, 95% CI 0.82-0.90). The CASPRI score predicted good neurological outcomes at discharge with an area under the curve of 0.748 (OR 0.86), outperforming the GO-FAR score (AUC 0.668) in patients with in-hospital cardiac arrest.
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