[Validation the clinical value of good outcome following attempted resuscitation scores in Chinese populations in predicting the prognosis of in-hospital cardiac arrest].

OBJECTIVE: To verify the clinical value of the good outcome following attempted resuscitation (GO-FAR) score in predicting the neurological status of patients with in-hospital cardiac arrest (IHCA) in the Chinese population. METHODS: The clinical data of patients with IHCA who were admitted to the Zigong Fourth People's Hospital from January 1 to December 31, 2020 were retrospectively analyzed. Used Glasgow-Pittsburgh cerebral performance category (CPC) score 1 point as the end point, the subjects were divided into 4 groups according to the score: ≤ 0 group, 1-8 group, 9-20 group and ≥ 21 group. Taken the group which GO-FAR score ≤ 0 as the reference group, the odds ratio (OR) of the other three groups compared with this group was calculated. The receiver operator characteristic curve (ROC curve) was performed to evaluate the predictive value of the GO-FAR score in favorable neurological outcome. A calibration curve was drawn for the Hosmer-Lemeshow test to analyze the degree of calibration of the GO-FAR score for predicting good neurological outcome. RESULTS: A total of 230 IHCA patients were enrolled in the study, including 130 males, aged 74 (65, 81) years old, and 23 case (10.0%) had good neurological prognosis. There were statistically significant differences in GO-FAR-related variables, including age, a normal neurological function on admitted, acute stroke, metastatic cancer, septicemia, medical noncardiac admission, hepatic insufficiency, hypotension, renal insufficiency or dialysis, respiratory insufficiency, pneumonia, etc (all P < 0.05). Taken the GO-FAR score ≤ 0 group as the reference group, the OR values of good neurological prognosis in the GO-FAR score 1-8 group were 0.54 [95% confidence interval (95%CI) was 0.17-1.53, P = 0.250], 9-20 group were 0.17 (95%CI was 0.02-0.67, P = 0.009) and ≥ 21 group were 0.25 (95%CI was 0.05-0.85, P = 0.025). The area under the ROC curve (AUC) of the GO-FAR score for predicting favorable neurological outcome in IHCA patients was 0.653 (95%CI was 0.529-0.777, P = 0.015) and there was no significant difference in Hosmer-Lemeshow test (P = 0.311). All these suggested that there was no significant difference between the predicted value and the actual value. CONCLUSIONS: GO-FAR score can be applied to predict neurological prognosis of IHCA patients in Chinese population. It can help clinicians to predict the prognosis of cardio-pulmonary resuscitation (CPR) and propose critical recommendations in treatment for these patients or their families.

Electronic healthcare records and external outcome data for hospitalized patients with heart failure.

Heart failure is one of the most important reasons for hospitalization among elderly individuals and is associated with significant mortality and morbidity. Epidemiological studies require the establishment of high-quality databases. Several datasets that primarily involve heart failure populations have been established in Western countries and have generated many high-quality studies. However, no such dataset is available from China. Due to differences in genetic background and healthcare systems between China and Western countries, the establishment of a heart failure database for the Chinese population is urgently needed. We performed a retrospective single-center observational study to collect data regarding the characteristics of heart failure patients in China by integrating electronic healthcare records and follow-up outcome data. The study collected information for a total of 2,008 patients with heart failure, containing 166 attributes.

False Lumen Status in Patients With Acute Aortic Dissection: A Systematic Review and Meta-Analysis.

BACKGROUND: The long-term association between the status of the false lumen and poor patient outcomes in acute aortic dissection (AAD) remains unclear. This systematic review and meta-analysis investigated whether the status of the false lumen was a predictor of poor long-term survival in AAD. METHODS AND RESULTS: Eleven cohort studies (2924 participants) exploring the association between the false lumen status and long-term outcomes (>1 year) in AAD were included. All studies reported multivariate-adjusted hazard ratios (HRs) with 95% CIs for long-term outcomes, according to false lumen status. Pooled HRs for mortality and aortic events were computed and weighted using generic inverse-variance and random-effect modeling. Residual patent false lumen was an independent predictor of long-term mortality in AAD type A (HR, 1.71; 95% CI, 1.16-2.52; P=0.007) and type B (HR, 2.79; 95% CI, 1.80-4.32; P<0.001). AAD patients with residual patent false lumen exhibited an increased risk of aortic events (HR, 5.43; 95% CI, 2.95-9.99; P<0.001). Partial false lumen thrombosis was independently associated with long-term mortality in type B AAD (HR, 2.24; 95% CI, 1.37-3.65; P=0.001). This association was not observed in AAD type A patients (HR, 1.75; 95% CI, 0.88-3.45; P=0.211). CONCLUSIONS: The false lumen status influences late outcomes in AAD. Residual patent false lumen is independently associated with poor long-term survival in AAD. However, only type B AAD patients with partial false lumen thrombosis had an increased late mortality risk.