Validation of the good outcome following attempted resuscitation score on in-hospital cardiac arrest in southern Sweden.

BACKGROUND: There is a great need for a simple and clinically useful instrument to help physicians estimate the probability of survival to discharge with a good neurological outcome (cerebral performance category, CPC=1) in cases of in-hospital cardiac arrest (IHCA). Our aim was to validate the "Good Outcome Following Attempted Resuscitation" (GO-FAR) score in a different country with different demographics than previously investigated. METHODS: A retrospective observational study including all cases of IHCA who were part of a cardiac arrest registry at Skåne University Hospital in Sweden 2007-2010. RESULTS: Two-hundred-eighty-seven patients suffered IHCA during the period. A majority were male and mean age was 70years. Overall survival to discharge independent of neurological function was 20.2%; 78% of the survivors had CPC=1 and survival to discharge with CPC=1 was 15.7%. The area under the receiver operating characteristics curve for the GO-FAR score was 0.85 (CI=0.78-0.91, p<0.001), consistent with very good discrimination. Patients in the group with low or very low probability of survival had a likelihood of 2.8% (95% CI 0.0-6.7), whereas the groups with average and above average probabilities had likelihoods of 8.2% (3.7-13) and 46% (34-58), respectively, for good neurological outcome. This compares with likelihoods of 1.6%, 9.2% and 27.8% in the original study. CONCLUSION: The GO-FAR score accurately predicted the probability of survival to discharge with CPC=1, even when applied to a different population in another country.