Risk prediction models for out-of-hospital cardiac arrest outcomes in England
| العنوان: | Risk prediction models for out-of-hospital cardiac arrest outcomes in England |
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| المؤلفون: | Chen Ji, James Mapstone, Rachael T Fothergill, Sarah Black, Robert Spaight, Scott J. Booth, Terry Brown, Jerry P. Nolan, Gavin D. Perkins, Claire Hawkes |
| المصدر: | Eur Heart J Qual Care Clin Outcomes |
| بيانات النشر: | Oxford University Press (OUP), 2020. |
| سنة النشر: | 2020 |
| مصطلحات موضوعية: | Emergency Medical Services, medicine.medical_specialty, medicine.medical_treatment, 030204 cardiovascular system & hematology, Return of spontaneous circulation, Logistic regression, State Medicine, 03 medical and health sciences, 0302 clinical medicine, medicine, Emergency medical services, Humans, Registries, Cardiopulmonary resuscitation, Survival analysis, business.industry, Health Policy, Area under the curve, 030208 emergency & critical care medicine, Original Articles, Cardiopulmonary Resuscitation, Regression, Brier score, Emergency medicine, Cardiology and Cardiovascular Medicine, business, RA, Out-of-Hospital Cardiac Arrest, RC |
| الوصف: | Aims The out-of-hospital cardiac arrest (OHCA) outcomes project is a national research registry. One of its aims is to explore sources of variation in OHCA survival outcomes. This study reports the development and validation of risk prediction models for return of spontaneous circulation (ROSC) at hospital handover and survival to hospital discharge. Methods and results The study included OHCA patients who were treated during 2014 and 2015 by emergency medical services (EMS) from seven English National Health Service ambulance services. The 2014 data were used to identify important variables and to develop the risk prediction models, which were validated using the 2015 data. Model prediction was measured by area under the curve (AUC), Hosmer–Lemeshow test, Cox calibration regression, and Brier score. All analyses were conducted using mixed-effects logistic regression models. Important factors included age, gender, witness/bystander cardiopulmonary resuscitation (CPR) combined, aetiology, and initial rhythm. Interaction effects between witness/bystander CPR with gender, aetiology and initial rhythm and between aetiology and initial rhythm were significant in both models. The survival model achieved better discrimination and overall accuracy compared with the ROSC model (AUC = 0.86 vs. 0.67, Brier score = 0.072 vs. 0.194, respectively). Calibration tests showed over- and under-estimation for the ROSC and survival models, respectively. A sensitivity analysis individually assessing Index of Multiple Deprivation scores and location in the final models substantially improved overall accuracy with inconsistent impact on discrimination. Conclusion Our risk prediction models identified and quantified important pre-EMS intervention factors determining survival outcomes in England. The survival model had excellent discrimination. |
| وصف الملف: | application/pdf |
| تدمد: | 2058-1742 2058-5225 1522-9645 |
| URL الوصول: | https://explore.openaire.eu/search/publication?articleId=doi_dedup___::f989a968c85fe30e847b2165ecda15fd https://doi.org/10.1093/ehjqcco/qcaa019 |
| حقوق: | OPEN |
| رقم الأكسشن: | edsair.doi.dedup.....f989a968c85fe30e847b2165ecda15fd |
| قاعدة البيانات: | OpenAIRE |
| تدمد: | 20581742 20585225 15229645 |
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