External validation of the TiPS65 score for predicting good neurological outcomes in patients with out-of-hospital cardiac arrest treated with extracorporeal cardiopulmonary resuscitation

被引：12

作者：

Makino, Yuto ^{[1
]}

Okada, Yohei ^{[1
]}

Irisawa, Taro ^{[2
]}

Yamada, Tomoki ^{[3
]}

Yoshiya, Kazuhisa ^{[4
]}

Park, Changhwi ^{[5
]}

Nishimura, Tetsuro ^{[6
]}

Ishibe, Takuya ^{[7
]}

Kobata, Hitoshi ^{[8
]}

Kiguchi, Takeyuki ^{[9
]}

Kishimoto, Masafumi ^{[10
]}

Kim, Sung-Ho ^{[11
]}

Ito, Yusuke ^{[12
]}

Sogabe, Taku ^{[13
]}

Morooka, Takaya ^{[14
]}

Sakamoto, Haruko ^{[15
]}

Suzuki, Keitaro ^{[16
]}

Onoe, Atsunori ^{[17
]}

Matsuyamar, Tasuku ^{[18
]}

Matsui, Satoshi ^{[19
]}

Nishioka, Norihiro ^{[1
]}

Yoshimuraa, Satoshi ^{[1
]}

Kimata, Shunsuke ^{[1
]}

Kawai, Shunsuke ^{[1
]}

Zha, Ling ^{[20
]}

Kiyohara, Kosuke ^{[21
]}

Kitamuras, Tetsuhisa

Iwami, Taku ^{[1
,22
]}

机构：

[1] Kyoto Univ, Dept Prevent Serv, Sch Publ Hlth, Kyoto, Japan

[2] Osaka Univ, Dept Traumatol & Acute Crit Med, Grad Sch Med, Suita, Japan

[3] Osaka Police Hosp, Emergency & Crit Care Med Ctr, Osaka, Japan

[4] Kansai Med Univ, Takii Hosp, Dept Emergency & Crit Care Med, Moriguchi, Japan

[5] Tane Gen Hosp, Dept Emergency Med, Osaka, Japan

[6] Osaka Metropolitan Univ, Dept Traumatol & Crit Care Med, Osaka, Japan

[7] Kindai Univ, Dept Emergency & Crit Care Med, Sch Med, Osaka, Japan

[8] Osaka Mishima Emergency Crit Care Ctr, Takatsuki, Japan

[9] Osaka Gen Med Ctr, Crit Care & Trauma Ctr, Osaka, Japan

[10] Osaka Prefectural Nakakawachi Med Ctr Acute Med, Osaka, Japan

[11] Senshu Trauma & Crit Care Ctr, Osaka, Japan

[12] Saiseikai Senri Hosp, Senri Crit Care Med Ctr, Suita, Japan

[13] Natl Hosp Org Osaka Natl Hosp, Traumatol & Crit Care Med Ctr, Osaka, Japan

[14] Osaka City Gen Hosp, Emergency & Crit Care Med Ctr, Osaka, Japan

[15] Osaka Red Cross Hosp, Dept Pediat, Osaka, Japan

[16] Kishiwada Tokushukai Hosp, Emergency & Crit Care Med Ctr, Osaka, Japan

[17] Kansai Med Univ, Dept Emergency & Crit Care Med cine, Hirakata, Osaka, Japan

[18] Kyoto Prefectural Univ Med, Dept Emergency Med, Kyoto, Japan

[19] Osaka Univ, Grad Sch Med, Dept Social & Environm Med, Div Environm Med & Populat Sci, Osaka, Japan

[20] Otsuma Womens Univ, Dept Food Sci, Tokyo, Japan

[21] Natl Univ Singapore, Duke NUS Med Sch, Hlth Serv & Syst Res, Singapore, Singapore

[22] Kyoto Univ, Sch Publ Hlth, Dept Prevent Serv, Yoshida Konoe Cho,Sakyo Ku, Kyoto 6068315, Japan

来源：

RESUSCITATION | 2023年 / 182卷

关键词：

Out-of-hospital cardiac arrest; Extracorporeal cardiopulmonary resuscitation; Prediction model; LOW-FLOW DURATION; ASSOCIATION;

D O I：

10.1016/j.resuscitation.2022.11.018

中图分类号：

R4 [临床医学];

学科分类号：

1002 ; 100602 ;

摘要：

Aim: Estimating prognosis of patients treated with extracorporeal cardiopulmonary resuscitation (ECPR) is essential for selecting candidates. The TiPS65 score can predict neurological outcomes of patients with out-of-hospital cardiac arrest (OHCA) treated with ECPR. We aimed to perform an external validation of this score. Methods: Data from the Japanese Association for Acute Medicine Out-of-Hospital Cardiac Arrest registry, a multicentred, nationwide, prospectively registered database, were analysed. All adult patients with OHCA and shockable rhythm and treated with ECPR between January 2018 to December 2019 were included. In the TiPS65 score, age, call-to-hospital arrival time, initial cardiac rhythm at hospital arrival, and initial pH value were used as predictors. The primary outcome was 30-day survival with favourable neurological outcomes (Cerebral Performance Category 1 or 2). Discrimina-tion, using the C-statistic, and predictive performances of each score, such as sensitivity and specificity, were investigated.Results: Of 590 included patients (517 [81.6%] men; median [interquartile range] age, 60 [50-69] years), 64 (10.8%) reported favourable neuro-logical outcomes. The C-statistic of the TiPS65 score was 0.729 (95% confidence interval (CI): 0.672-0.786). When the cut-off of TiPS65 score was setto >1, the sensitivity and specificity were 0.906 (95%CI: 0.807-0.965) and 0.430 (95%CI: 0.387-0.473), respectively; conversely, when the cut-off was set to >3, they were 0.172 (95%CI: 0.089-0.287) and 0.971 (95%CI: 0.953-0.984), respectively.Conclusions: The TiPS65 score shows reasonable discrimination and predictive performances. This score can be supportive in the decision-making process for the selection of eligible patients for ECPR in clinical settings.

引用

页数：8

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