• Bertrand Sauneuf, Julien Dupeyrat, Xavier Souloy, Maxime Leclerc, Benoit Courteille, Bertrand Canoville, Michel Ramakers, Frédéric Goddé, Farzin Beygui, du CheyronDamienDService de Réanimation Médicale, Ce... more ntre Hospitalier Universitaire de Caen, Avenue de la côte de Nacre, 14033 Caen, France., and Cédric Daubin. less
• Service de Réanimation, Médecine Intensive, Centre Hospitalier Public du Cotentin, BP 208, 50102 Cherbourg-en-Cotentin, France. Electronic address: b.sauneuf@ch-cotentin.fr.
• Resuscitation. 2020 Mar 1; 148: 200-206.

BackgroundOlder age is associated with worse outcome after out-of-hospital cardiac arrest (OHCA). Therefore, we tested the performance of CAHP score, to predict neurological outcome in elderly OHCA patients and to select patients most likely to benefit from coronary angiogram (CAG).Materials And MethodsThe present study was a retrospective multicentre observational study at 3 non-university hospitals and 1 university hospital. CAHP score was calculated, and its performance to predict outcomes was evaluated. Factors associated with the use of CAG were analysed and the rate of CAG across each CAHP score risk group reported.ResultsOne hundred seventy-six patients fulfilled inclusion criteria (median age of 81, [79-84]), among which a cardiac cause was presumed for 99 patients. The hospital unfavourable outcome was 91%. The ROC-AUC values for hospital neurological outcome prediction of CAHP score was 0.81 [0.68-0.94], showing good discrimination performance. ST-segment elevation in ECG and initial shockable rhythm were independent factors for performing early CAG, whereas age and distance from the percutaneous coronary intervention centre were independently associated with the absence of early CAG. The percentages of patients receiving early CAG in the low, medium and high CAHP score risk groups were 64%, 33% and 34%, respectively, and differed significantly between low CAHP score risk group and other groups (p = 0.02).ConclusionsThe CAHP score exhibited a good discrimination performance to predict neurological outcome in elderly OHCA patients. This score could represent a helpful tool for treatment allocation. A simple prognostication score could permit avoiding unnecessary procedures in patients with minimal chances of survival.Copyright © 2020 Elsevier B.V. All rights reserved.

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