A novel score to predict in-hospital mortality for patients with acute coronary syndrome and out-of-hospital cardiac arrest: the FACTOR study

29/02/2024 2 min

Listen "A novel score to predict in-hospital mortality for patients with acute coronary syndrome and out-of-hospital cardiac arrest: the FACTOR study"

Episode Synopsis

A novel score to predict in-hospital mortality for patients with acute coronary syndrome and out-of-hospital cardiac
arrest: the FACTOR study
Clin Res Cardiol . 2024 Feb 8. doi: 10.1007/s00392-023-02367-1.
 
Abstract
Introduction: Acute coronary syndromes (ACS) represent a substantial global healthcare challenge. In its most severe form,
it can lead to out-of-hospital cardiac arrest (OHCA). Despite medical advancements, survival rates in OHCA patients remain low. Further, the prediction of outcomes in these patients poses a challenge to all health care providers involved. This study aims at developing a score with variables
available on admission to assess in-hospital mortality of patients with OHCA undergoing coronary angiography.
 
Method: All patients with OHCA due to ACS admitted to
a tertiary care center were included. A multivariate logistic regression analysis was conducted to explore the association between clinical variables and in-hospital all-cause mortality. A scoring system incorporating variables available upon
admission to assess individual patients' risk of in-hospital mortality was developed (FACTOR score). The score was then validated.
 
Results: A total of 291 patients were included in the
study, with a median age of 65 [56-73] years, including 47 women (16.2%). The in-hospital mortality rate was 41.2%. A prognostic model was developed in the derivation cohort (n = 138) and included the following variables: age, downtime,
first detected rhythm, and administration of epinephrine. The area under the curve for the FACTOR score was 0.823 (95% CI 0.737-0.894) in the derivation cohort and 0.828 (0.760-0.891) in the validation cohort (n = 153).
 
Conclusion: The FACTOR score demonstrated a reliable
prognostic tool for health care providers in assessing in-hospital mortality of OHCA patients. Early acknowledgement of a poor prognosis may help in patient management and allocation of resources.

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