| Title: |
Derivation and Validation of the CREST Model for Very Early Prediction of Circulatory Etiology Death in Patients Without ST-Segment–Elevation Myocardial Infarction After Cardiac Arrest |
| Authors: |
Bascom, Karen E.; Dziodzio, John; Vasaiwala, Samip; Mooney, Michael; Patel, Nainesh; McPherson, John; McMullan, Paul; Unger, Barbara; Nielsen, Niklas; Friberg, Hans; Riker, Richard R.; Kern, Karl B.; Duarte, Christine W.; Seder, David B.; May, Teresa; Sunde, Kjetil; Rubertsson, Sten; Smid, Ondrej; Soreide, Eldar; Hand, Robert; Rundgren, Malin; Valsson, Felix; Sadaka, Farid; Bekkers, Bas; Wanscher, Michael; Lindell, Eva-Lotta; Guldbrand, Pehr; Torstensson, Anders; Dybkowska, Krystyna; Israelsson, Johan; Skram, Ulrik; Guzowski, Michelle; Hopf, Hans-Bernd; Persson, Stefan; Chang, Ira; Samuelsson, Line; Oddby, Eva; Savolainen, Kristina; Zätterman, Richard; Rodriguez, Daniel; Mayer, Stephan; Födisch, Markus; Oscarsson, Beata; Scheer, Håkan; Sarbinowski, Roman; Hyddmark, Ulf; Deye, Nicolas; Lindbom, Anna; Armani, Claudia; Forsberg, Sune |
| Source: |
Circulation ; volume 137, issue 3, page 273-282 ; ISSN 0009-7322 1524-4539 |
| Publisher Information: |
Ovid Technologies (Wolters Kluwer Health) |
| Publication Year: |
2018 |
| Description: |
Background: No practical tool quantitates the risk of circulatory-etiology death (CED) immediately after successful cardiopulmonary resuscitation in patients without ST-segment–elevation myocardial infarction. We developed and validated a prediction model to rapidly determine that risk and facilitate triage to individualized treatment pathways. Methods: With the use of INTCAR (International Cardiac Arrest Registry), an 87-question data set representing 44 centers in the United States and Europe, patients were classified as having had CED or a combined end point of neurological-etiology death or survival. Demographics and clinical factors were modeled in a derivation cohort, and backward stepwise logistic regression was used to identify factors independently associated with CED. We demonstrated model performance using area under the curve and the Hosmer-Lemeshow test in the derivation and validation cohorts, and assigned a simplified point-scoring system. Results: Among 638 patients in the derivation cohort, 121 (18.9%) had CED. The final model included preexisting coronary artery disease (odds ratio [OR], 2.86; confidence interval [CI], 1.83–4.49; P ≤0.001), nonshockable rhythm (OR, 1.75; CI, 1.10–2.77; P=0.017), initial ejection fraction25 minutes) of 0 to 5 was: 7.1% versus 10.2%, 9.5% versus 11%, 22.5% versus 19.6%, 32.4% versus 29.6%, 38.5% versus 30%, and 55.7% versus ... |
| Document Type: |
article in journal/newspaper |
| Language: |
English |
| DOI: |
10.1161/circulationaha.116.024332 |
| DOI: |
10.1161/CIRCULATIONAHA.116.024332 |
| Availability: |
https://doi.org/10.1161/circulationaha.116.024332; https://www.ahajournals.org/doi/full/10.1161/CIRCULATIONAHA.116.024332 |
| Accession Number: |
edsbas.C1DDF2D8 |
| Database: |
BASE |