Resident Physician Philadelphia, Pennsylvania, United States
Disclosure(s):
Syed Muhammad Saad Jalil, MD: No financial relationships to disclose
Background: Extracorporeal cardiopulmonary resuscitation (ECPR) is an advanced rescue therapy for patients with refractory in-hospital cardiac arrest. The Rescue-IHCA score is a recently developed risk stratification tool designed to predict mortality in patients undergoing ECPR. We performed an institutional evaluation of the Rescue-IHCA score in our diverse cohort.
Methods: We conducted a retrospective, single-center study of adult patients who underwent ECPR for refractory in-hospital cardiac arrest. A total of 70 patients were included. The Rescue-IHCA score was calculated for each patient. Discriminatory performance for in-hospital mortality was assessed using receiver operating characteristic (ROC) curve analysis, and the association between score and mortality was evaluated using logistic regression.
Outcome: Overall, in-hospital mortality was 73% (51/70) in the study cohort. The Rescue-IHCA score demonstrated excellent discrimination for in-hospital mortality, with an area under the ROC curve (AUC) of 0.86 (95% confidence interval [CI], 0.75–0.96; p < 0.001). Each one-point increase in the Rescue-IHCA score was associated with a 20% increase in the odds of in-hospital mortality (odds ratio [OR] 1.20; 95% CI, 1.10–1.31; p < 0.001).
Conclusion: In our institutional ECPR cohort, the Rescue-IHCA score demonstrated excellent discriminatory performance for predicting in-hospital mortality. These findings support the clinical utility of the Rescue-IHCA score as a prognostic tool to aid risk stratification and decision-making in patients considered for ECPR following in-hospital cardiac arrest.
