Scoring Systems to Predict Survival or Neurological Recovery after Out-of-hospital Cardiac Arrest

Abstract

Numerous prediction scores have been developed to better inform clinical decision-making following out-of-hospital cardiac arrest (OHCA), however, there is no consensus among clinicians over which score to use. The aim of this review was to identify and compare scoring systems to predict survival and neurological recovery in patients with OHCA. A structured literature search of the MEDLINE database was carried out from inception to December 2021. Studies developing or validating scoring systems to predict outcome following OHCA were selected. Relevant data were extracted and synthesised for narrative review. In total, 16 scoring systems were identified: one predicting the probability of return of spontaneous circulation, six predicting survival to hospital discharge and nine predicting neurological outcome. NULL-PLEASE and CAST are recommended as the best scores to predict mortality and neurological outcome, respectively, due to the extent of external validation, ease of use and high predictive value of the variables. Whether use of these scores can lead to more cost-effective service delivery remains unclear.