SPC365

Beyond the Arrest: Assessing survival with SOFA and SAPS II Scores in OHCA patients

Session: Sessão de Posters 04 - Choque cardiogénico
Speaker: Diogo Rosa Ferreira

Congress: CPC 2024
Topic: E. Coronary Artery Disease, Acute Coronary Syndromes, Acute Cardiac Care
Theme: 14. Acute Cardiac Care
Subtheme: 14.5 Acute Cardiac Care – Cardiac Arrest
Session Type: Cartazes
FP Number: ---
Authors: Diogo Ferreira; Marta Vilela; Catarina Oliveira; Ana Beatriz Garcia; Ana Margarida Martins; Carolina Robalo; João Cravo; João Ribeiro; Fausto Pinto; Doroteia Silva

<p style="text-align:justify"><span style="font-size:12px"><span style="font-family:Arial,Helvetica,sans-serif"><strong>Introduction:</strong></span></span></p>

<p style="text-align:justify"><span style="font-size:12px"><span style="font-family:Arial,Helvetica,sans-serif">Out-of-hospital cardiac arrest (OHCA) is a global health concern with millions of cases yearly. Survival depends on factors like witnessed events, timely cardiopulmonary resuscitation, and initial shockable rhythms. Despite typically being admitted to intensive care units (ICUs), validated scores for post-admission survival prediction are lacking. Widely used ICU tools such as the Sequential Organ Failure Assessment (SOFA) and the Simplified Acute Physiology Score II (SAPS II)&nbsp; to forecast clinical outcomes lack validation for predicting overall mortality in OHCA patients.</span></span></p>

<p style="text-align:justify">&nbsp;</p>

<p style="text-align:justify"><span style="font-size:12px"><span style="font-family:Arial,Helvetica,sans-serif"><strong>Methods:</strong></span></span></p>

<p style="text-align:justify"><span style="font-size:12px"><span style="font-family:Arial,Helvetica,sans-serif">Retrospective, observational, single-center study conducted on patients admitted to a polyvalent ICU unit of a tertiary hospital following OHCA between 2017-2019.&nbsp; SOFA and SAPS II scores calculated in the first 24 hours of admission were divided into tertile groups to determine whether a correlation between these scores and time to death could be identified. Kaplan-Meier survival analysis was performed.</span></span></p>

<p style="text-align:justify">&nbsp;</p>

<p style="text-align:justify"><span style="font-size:12px"><span style="font-family:Arial,Helvetica,sans-serif"><strong>Results:&nbsp;</strong></span></span></p>

<p style="text-align:justify"><span style="font-size:12px"><span style="font-family:Arial,Helvetica,sans-serif">The study included 79 OHCA patients, with 32.9% being female. 84,8% of the cardiac arrests were witnessed, and 39.2% occurred at home. Sixty patients (75,9%) died during follow-up (FUP). Mean FUP time for surviving patients was 3,9 years. All patients had SOFA and SAPS II scores calculated within the first 24 hours post-arrest.</span></span></p>

<p style="text-align:justify"><span style="font-size:12px"><span style="font-family:Arial,Helvetica,sans-serif">SAPS II score first tertile was 50 and second tertile was 68. Patients with SAPS II score from 51 to 68 had a greater risk of mortality (HR: 3.17; 95% CI: 1.28-7.86, p=0.013) relative to patients under or equal to 50 and patients with SAPS II score greater than 68 had around 4,6 times the risk of mortality when compared to patients under 51 (HR: 4.64;95%CI: 1.90-11.32, p&lt;0.001) .</span></span></p>

<p style="text-align:justify"><span style="font-size:12px"><span style="font-family:Arial,Helvetica,sans-serif">SOFA score within the first tertile was under or equal to 7. The second tertile was 10.&nbsp;</span></span></p>

<p style="text-align:justify"><span style="font-size:12px"><span style="font-family:Arial,Helvetica,sans-serif">Patients within the second tertile (SOFA score from 8 to 10) had a greater risk of mortality relative to patients with a SOFA score under or equal to 7 (HR: 2,19, 95% CI: 1,06-4,52, p=0,03) and patients with SOFA score greater than 10 had 2,5 times the risk (HR: 2,54, 95% CI: 1,24-5,22, p=0,01) of mortality when compared to patients within the first tertile (under or equal to 7). There was not a statistically significant difference in the risk of mortality in patients with SOFA score from 8 to 10 and patients with SOFA score greater than 10.</span></span></p>

<p style="text-align:justify">&nbsp;</p>

<p style="text-align:justify"><span style="font-size:12px"><span style="font-family:Arial,Helvetica,sans-serif"><strong>Conclusion:&nbsp;</strong></span></span></p>

<p style="text-align:justify"><span style="font-size:12px"><span style="font-family:Arial,Helvetica,sans-serif">SOFA and SAPS II scores calculated within the first 24h can be applied to estimate mortality risk&nbsp; in OHCA patients admitted to an ICU.</span></span></p>