PhD Scientific Days 2021

Budapest, 7-8 July 2021

CL_II_P: Clinical Medicine II. Posters

Prospective analysis of FORECAST pilot score for estimation the early mortality in resuscitated patients

Boldizsár Kiss 1 , Bettina Nagy 1 , Gábor Tamás Dér 1, Béla Merkely 1, Endre Zima 1

1 Semmelweis University, Heart and Vascular Centre, Budapest

Text of the abstract

Introduction: Sudden cardiac death (SCD) is one of the most significant cardiovascular causes of death. In the treatment of SCD – following a successful cardiopulmonary resuscitation (CPR) – patients often require complex intensive care. Currently there are only a few validated score systems given to quickly and reliably estimate the mortality risk and the optimal short and long term outcome of these patients.

Aims: Our aim was to develop a scoring system that quickly, accurately, and reliably estimates mortality in patients undergoing CPR and intensive care in the first few hours. In addition to cardiovascular risk factors that indicate haemodynamic instability, we also investigated factors, that potentially worsen the outcome of CPR.

Method: Between 2019 and 2020, we enrolled 49 patients in our prospective, non-interventional clinical trial who underwent successful CPR, were 18 years of age, and were treated in the cardiology ICU of the Heart and Vascular Centre. During the care of these patients, data on anamnestic, CPR conditions, and intensive care were analyzed according to scheduled sampling. The FORECAST maximum point is 16.

Results: According to Cox-regression early mortality was significantly reduced by age under 75 years (p:0.065, OR:0,448 [0,191-1,051]), eGFR above 60 (p:0.025, OR:0,429 [0,204-0,901]), and initial shockable rhythm (p:0.066, OR:0.501 [0.240-1.046]). Early mortality was significantly increased by age over 75 years (p:0.065, OR: 2.235 [0.952-5.246]), previous CABG surgery (p:0.022, OR: 3.302[1.138-9.585]), eGFR below 60 (p:0.025, OR:2.332 [1.110-4.902]), and non-shockable initial rhythm (p:0.066, OR:1.997[0.965-4.168]).

Conclusion: The early mortality of a successfully resuscitated patient is clearly determined by age, previous CABG surgery, eGFR at admission, and initial rhythm. For the other variables, with this number of items, we did not find a clear correlation with early mortality. Further refinement of the score system is still needed with the continuation of the prospective study.

University and Doctoral School

Semmelweis University, Doctoral School of Theoretical and Translational Medicine