Faxén, J, Hall, M orcid.org/0000-0003-1246-2627, Gale, CP orcid.org/0000-0003-4732-382X et al. (4 more authors) (2017) A user-friendly risk-score for predicting in-hospital cardiac arrest among patients admitted with suspected non ST-elevation acute coronary syndrome – the SAFER-score. Resuscitation, 121. pp. 41-48. ISSN 0300-9572
Abstract
Aim: To develop a simple risk-score model for predicting in-hospital cardiac arrest (CA) among patients hospitalized with suspected non-ST elevation acute coronary syndrome (NSTE-ACS). Methods: Using the Swedish Web-system for Enhancement and Development of Evidence-based care in Heart disease Evaluated According to Recommended Therapies (SWEDEHEART), we identified patients (n = 242 303) admitted with suspected NSTE-ACS between 2008 and 2014. Logistic regression was used to assess the association between 26 candidate variables and in-hospital CA. A risk-score model was developed and validated using a temporal cohort (n = 126 073) comprising patients from SWEDEHEART between 2005 and 2007 and an external cohort (n = 276 109) comprising patients from the Myocardial Ischaemia National Audit Project (MINAP) between 2008 and 2013. Results: The incidence of in-hospital CA for NSTE-ACS and non-ACS was lower in the SWEDEHEART-derivation cohort than in MINAP (1.3% and 0.5% vs. 2.3% and 2.3%). A seven point, five variable risk score (age ≥60 years (1 point), ST-T abnormalities (2 points), Killip Class >1 (1 point), heart rate <50 or ≥100 bpm (1 point), and systolic blood pressure <100 mmHg (2 points) was developed. Model discrimination was good in the derivation cohort (c-statistic 0.72) and temporal validation cohort (c-statistic 0.74), and calibration was reasonable with a tendency towards overestimation of risk with a higher sum of score points. External validation showed moderate discrimination (c-statistic 0.65) and calibration showed a general underestimation of predicted risk. Conclusions: A simple points score containing five variables readily available on admission predicts in-hospital CA for patients with suspected NSTE-ACS.
Metadata
Item Type: | Article |
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Authors/Creators: |
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Copyright, Publisher and Additional Information: | © 2017 Elsevier B.V. This is an author produced version of a paper published in Resuscitation. Uploaded in accordance with the publisher's self-archiving policy. |
Keywords: | In-Hospital Cardiac Arrest; Acute Coronary Syndrome; Non-ST Elevation Acute Coronary Syndrome; Risk Score; Risk Stratification |
Dates: |
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Institution: | The University of Leeds |
Academic Units: | The University of Leeds > Faculty of Medicine and Health (Leeds) > School of Medicine (Leeds) > Leeds Institute of Cardiovascular and Metabolic Medicine (LICAMM) |
Depositing User: | Symplectic Publications |
Date Deposited: | 10 Oct 2017 08:26 |
Last Modified: | 06 Oct 2018 00:39 |
Status: | Published |
Publisher: | Elsevier |
Identification Number: | 10.1016/j.resuscitation.2017.10.004 |
Open Archives Initiative ID (OAI ID): | oai:eprints.whiterose.ac.uk:122312 |