Validation of the return of spontaneous circulation after cardiac arrest (RACA) score in two different national territories

Maria Luce Caputo, Enrico Baldi, Simone Savastano, Roman Burkart, Claudio Benvenuti, Catherine Klersy, Roberto Cianella, Luciano Anselmi, Tiziano Moccetti, Romano Mauri, Gaetano M De Ferrari, Angelo Auricchio

Research output: Contribution to journalArticle

Abstract

BACKGROUND: The likelihood of return of spontaneous circulation (ROSC) after out-of-hospital cardiac arrest (OHCA) is influenced by unmodifiable (gender, aetiology, location, the presence of witnesses and initial rhythm) and modifiable factors (bystander CPR and the time to EMS arrival). All of these have been included in the ROSC After Cardiac Arrest (RACA) score.

PURPOSE: To test the ability of the RACA score to predict the probability of ROSC in two different regions with different local resuscitation networks: the Swiss Canton Ticino and the Italian Province of Pavia.

METHODS AND RESULTS: All OHCAs occurred between January 1st 2015 and December 31st 2017 were included. The original regression coefficients for all RACA score variables were applied. The probability to obtain the ROSC as measured with the RACA score was divided in tertiles. Overall, 2041 OHCAs were included in the analysis. The RACA score showed good discrimination for ROSC (AUC 0.76) and calibration, without interaction (p 0.28) between the region and the probability of ROSC. The probability of ROSC was 15% for RACA scores <0.28, 20% for RACA scores between 0.28 and 0.42, increasing to 55% for RACA scores >0.42.

CONCLUSIONS: The application of the RACA score reliably assess the probability to obtain the ROSC, with equal effectiveness in the two regions, despite different organization of the resuscitation network. Patients with a RACA score >0.42 had more than 50% probability to obtain ROSC.

Original languageEnglish
Pages (from-to)62-68
Number of pages7
JournalResuscitation
Volume134
DOIs
Publication statusE-pub ahead of print - Nov 14 2018

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Heart Arrest
Resuscitation
Out-of-Hospital Cardiac Arrest
Cardiopulmonary Resuscitation
Calibration
Area Under Curve

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Validation of the return of spontaneous circulation after cardiac arrest (RACA) score in two different national territories. / Caputo, Maria Luce; Baldi, Enrico; Savastano, Simone; Burkart, Roman; Benvenuti, Claudio; Klersy, Catherine; Cianella, Roberto; Anselmi, Luciano; Moccetti, Tiziano; Mauri, Romano; De Ferrari, Gaetano M; Auricchio, Angelo.

In: Resuscitation, Vol. 134, 14.11.2018, p. 62-68.

Research output: Contribution to journalArticle

Caputo, Maria Luce ; Baldi, Enrico ; Savastano, Simone ; Burkart, Roman ; Benvenuti, Claudio ; Klersy, Catherine ; Cianella, Roberto ; Anselmi, Luciano ; Moccetti, Tiziano ; Mauri, Romano ; De Ferrari, Gaetano M ; Auricchio, Angelo. / Validation of the return of spontaneous circulation after cardiac arrest (RACA) score in two different national territories. In: Resuscitation. 2018 ; Vol. 134. pp. 62-68.
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title = "Validation of the return of spontaneous circulation after cardiac arrest (RACA) score in two different national territories",
abstract = "BACKGROUND: The likelihood of return of spontaneous circulation (ROSC) after out-of-hospital cardiac arrest (OHCA) is influenced by unmodifiable (gender, aetiology, location, the presence of witnesses and initial rhythm) and modifiable factors (bystander CPR and the time to EMS arrival). All of these have been included in the ROSC After Cardiac Arrest (RACA) score.PURPOSE: To test the ability of the RACA score to predict the probability of ROSC in two different regions with different local resuscitation networks: the Swiss Canton Ticino and the Italian Province of Pavia.METHODS AND RESULTS: All OHCAs occurred between January 1st 2015 and December 31st 2017 were included. The original regression coefficients for all RACA score variables were applied. The probability to obtain the ROSC as measured with the RACA score was divided in tertiles. Overall, 2041 OHCAs were included in the analysis. The RACA score showed good discrimination for ROSC (AUC 0.76) and calibration, without interaction (p 0.28) between the region and the probability of ROSC. The probability of ROSC was 15{\%} for RACA scores <0.28, 20{\%} for RACA scores between 0.28 and 0.42, increasing to 55{\%} for RACA scores >0.42.CONCLUSIONS: The application of the RACA score reliably assess the probability to obtain the ROSC, with equal effectiveness in the two regions, despite different organization of the resuscitation network. Patients with a RACA score >0.42 had more than 50{\%} probability to obtain ROSC.",
author = "Caputo, {Maria Luce} and Enrico Baldi and Simone Savastano and Roman Burkart and Claudio Benvenuti and Catherine Klersy and Roberto Cianella and Luciano Anselmi and Tiziano Moccetti and Romano Mauri and {De Ferrari}, {Gaetano M} and Angelo Auricchio",
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T1 - Validation of the return of spontaneous circulation after cardiac arrest (RACA) score in two different national territories

AU - Caputo, Maria Luce

AU - Baldi, Enrico

AU - Savastano, Simone

AU - Burkart, Roman

AU - Benvenuti, Claudio

AU - Klersy, Catherine

AU - Cianella, Roberto

AU - Anselmi, Luciano

AU - Moccetti, Tiziano

AU - Mauri, Romano

AU - De Ferrari, Gaetano M

AU - Auricchio, Angelo

N1 - Copyright © 2018 Elsevier B.V. All rights reserved.

PY - 2018/11/14

Y1 - 2018/11/14

N2 - BACKGROUND: The likelihood of return of spontaneous circulation (ROSC) after out-of-hospital cardiac arrest (OHCA) is influenced by unmodifiable (gender, aetiology, location, the presence of witnesses and initial rhythm) and modifiable factors (bystander CPR and the time to EMS arrival). All of these have been included in the ROSC After Cardiac Arrest (RACA) score.PURPOSE: To test the ability of the RACA score to predict the probability of ROSC in two different regions with different local resuscitation networks: the Swiss Canton Ticino and the Italian Province of Pavia.METHODS AND RESULTS: All OHCAs occurred between January 1st 2015 and December 31st 2017 were included. The original regression coefficients for all RACA score variables were applied. The probability to obtain the ROSC as measured with the RACA score was divided in tertiles. Overall, 2041 OHCAs were included in the analysis. The RACA score showed good discrimination for ROSC (AUC 0.76) and calibration, without interaction (p 0.28) between the region and the probability of ROSC. The probability of ROSC was 15% for RACA scores <0.28, 20% for RACA scores between 0.28 and 0.42, increasing to 55% for RACA scores >0.42.CONCLUSIONS: The application of the RACA score reliably assess the probability to obtain the ROSC, with equal effectiveness in the two regions, despite different organization of the resuscitation network. Patients with a RACA score >0.42 had more than 50% probability to obtain ROSC.

AB - BACKGROUND: The likelihood of return of spontaneous circulation (ROSC) after out-of-hospital cardiac arrest (OHCA) is influenced by unmodifiable (gender, aetiology, location, the presence of witnesses and initial rhythm) and modifiable factors (bystander CPR and the time to EMS arrival). All of these have been included in the ROSC After Cardiac Arrest (RACA) score.PURPOSE: To test the ability of the RACA score to predict the probability of ROSC in two different regions with different local resuscitation networks: the Swiss Canton Ticino and the Italian Province of Pavia.METHODS AND RESULTS: All OHCAs occurred between January 1st 2015 and December 31st 2017 were included. The original regression coefficients for all RACA score variables were applied. The probability to obtain the ROSC as measured with the RACA score was divided in tertiles. Overall, 2041 OHCAs were included in the analysis. The RACA score showed good discrimination for ROSC (AUC 0.76) and calibration, without interaction (p 0.28) between the region and the probability of ROSC. The probability of ROSC was 15% for RACA scores <0.28, 20% for RACA scores between 0.28 and 0.42, increasing to 55% for RACA scores >0.42.CONCLUSIONS: The application of the RACA score reliably assess the probability to obtain the ROSC, with equal effectiveness in the two regions, despite different organization of the resuscitation network. Patients with a RACA score >0.42 had more than 50% probability to obtain ROSC.

U2 - 10.1016/j.resuscitation.2018.11.012

DO - 10.1016/j.resuscitation.2018.11.012

M3 - Article

C2 - 30447262

VL - 134

SP - 62

EP - 68

JO - Resuscitation

JF - Resuscitation

SN - 0300-9572

ER -