학술논문

External Validation of the CAST and rCAST Score in Patients With Out‐of‐Hospital Cardiac Arrest Who Underwent Extracorporeal Cardiopulmonary Resuscitation: A Secondary Analysis of the SAVE‐J II Study
Document Type
article
Source
Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease, Vol 13, Iss 1 (2024)
Subject
CAST
neurological prognosis
post–cardiac arrest syndrome
rCAST
risk classification
Diseases of the circulatory (Cardiovascular) system
RC666-701
Language
English
ISSN
2047-9980
Abstract
Background Risk stratification is important in patients with post–cardiac arrest syndrome. The Post‐Cardiac Arrest Syndrome for Therapeutic Hypothermia (CAST) and revised CAST (rCAST) scores have been well validated for predicting neurological outcomes, particularly for conventionally resuscitated patients with post–cardiac arrest syndrome. However, no studies have evaluated patients undergoing extracorporeal cardiopulmonary resuscitation. Methods and Results Adult patients with out‐of‐hospital cardiac arrest who underwent extracorporeal cardiopulmonary resuscitation were analyzed in this retrospective observational multicenter cohort study. We validated the accuracy of the CAST/rCAST scores for predicting neurological outcomes at 30 days. Moreover, we compared the predictive performance of these scores with the TiPS65 risk score derived from patients with out‐of‐hospital cardiac arrest who were resuscitated using extracorporeal cardiopulmonary resuscitation. A total of 1135 patients were analyzed. The proportion of patients with favorable neurological outcomes was 16.6%. In the external validation, the area under the receiver operating characteristic curve of the CAST score was significantly higher than that of the rCAST score (area under the receiver operating characteristic curve 0.677 versus 0.603; P