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Open Access 08-02-2024 | Acute Coronary Syndrome | Original Paper

A novel score to predict in-hospital mortality for patients with acute coronary syndrome and out-of-hospital cardiac arrest: the FACTOR study

Authors: Victor Schweiger, Pauline Hiller, Rahel Utters, Angela Fenice, Victoria Lucia Cammann, Davide Di Vece, Katja Rajman, Alessandro Candreva, Alexander Gotschy, Thomas Gilhofer, Michael Würdinger, Barbara E. Stähli, Burkhardt Seifert, Stefan M. Müller, Christian Templin, Julia Stehli

Published in: Clinical Research in Cardiology | Issue 4/2024

Abstract

Introduction

Acute coronary syndromes (ACS) represent a substantial global healthcare challenge. In its most severe form, it can lead to out-of-hospital cardiac arrest (OHCA). Despite medical advancements, survival rates in OHCA patients remain low. Further, the prediction of outcomes in these patients poses a challenge to all health care providers involved. This study aims at developing a score with variables available on admission to assess in-hospital mortality of patients with OHCA undergoing coronary angiography.

Method

All patients with OHCA due to ACS admitted to a tertiary care center were included. A multivariate logistic regression analysis was conducted to explore the association between clinical variables and in-hospital all-cause mortality. A scoring system incorporating variables available upon admission to assess individual patients' risk of in-hospital mortality was developed (FACTOR score). The score was then validated.

Results

A total of 291 patients were included in the study, with a median age of 65 [56–73] years, including 47 women (16.2%). The in-hospital mortality rate was 41.2%. A prognostic model was developed in the derivation cohort (n = 138) and included the following variables: age, downtime, first detected rhythm, and administration of epinephrine. The area under the curve for the FACTOR score was 0.823 (95% CI 0.737–0.894) in the derivation cohort and 0.828 (0.760–0.891) in the validation cohort (n = 153).

Conclusion

The FACTOR score demonstrated a reliable prognostic tool for health care providers in assessing in-hospital mortality of OHCA patients. Early acknowledgement of a poor prognosis may help in patient management and allocation of resources.

Graphical abstract

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Title: A novel score to predict in-hospital mortality for patients with acute coronary syndrome and out-of-hospital cardiac arrest: the FACTOR study
Authors: Victor Schweiger
Pauline Hiller
Rahel Utters
Angela Fenice
Victoria Lucia Cammann
Davide Di Vece
Katja Rajman
Alessandro Candreva
Alexander Gotschy
Thomas Gilhofer
Michael Würdinger
Barbara E. Stähli
Burkhardt Seifert
Stefan M. Müller
Christian Templin
Julia Stehli
Publication date: 08-02-2024
Publisher: Springer Berlin Heidelberg
Keywords: Acute Coronary Syndrome
Cardiopulmonary Resuscitation
Published in: Clinical Research in Cardiology / Issue 4/2024
Print ISSN: 1861-0684
Electronic ISSN: 1861-0692
DOI: https://doi.org/10.1007/s00392-023-02367-1

Keynote webinar | Spotlight on medication adherence

Springer Medicine

A novel score to predict in-hospital mortality for patients with acute coronary syndrome and out-of-hospital cardiac arrest: the FACTOR study

Abstract

Introduction

Method

Results

Conclusion

Graphical abstract

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Introduction

Method

Results

Conclusion

Graphical abstract

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