Association of a simple SACAF score with bystander witnessed sudden death due to ventricular tachyarrhythmias in a multicenter cohort

Abstract Out-of-hospital cardiac arrest (OHCA) remains a major threat to public health worldwide. OHCA patients presenting initial shockable ventricular tachycardia/ventricular fibrillation (VT/VF) rhythm have a better survival rate. We sought to develop a simple SACAF score to discriminate VT/VF fr...

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Autores principales:	Mei-Yao Wu, Ming-Shien Wen, Mien-Cheng Chen, Chia-Ti Tsai, Tsu-Juey Wu, Wei-Chieh Lee, Yen-Nien Lin, Shih-Sheng Chang, Kuan-Cheng Chang
Formato:	article
Lenguaje:	EN
Publicado:	Nature Portfolio 2021
Materias:	Medicine R Science Q
Acceso en línea:	https://doaj.org/article/3ed25af173d542c089ef1bc0e2685371
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spelling	oai:doaj.org-article:3ed25af173d542c089ef1bc0e26853712021-11-08T10:56:05ZAssociation of a simple SACAF score with bystander witnessed sudden death due to ventricular tachyarrhythmias in a multicenter cohort10.1038/s41598-021-00940-02045-2322https://doaj.org/article/3ed25af173d542c089ef1bc0e26853712021-11-01T00:00:00Zhttps://doi.org/10.1038/s41598-021-00940-0https://doaj.org/toc/2045-2322Abstract Out-of-hospital cardiac arrest (OHCA) remains a major threat to public health worldwide. OHCA patients presenting initial shockable ventricular tachycardia/ventricular fibrillation (VT/VF) rhythm have a better survival rate. We sought to develop a simple SACAF score to discriminate VT/VF from non-VT/VF OHCAs based on the Taiwan multicenter hospital-based registry database. We analyzed the in- and pre-hospital data, including demographics, baseline comorbidities, response times, automated external defibrillator information, and the 12-lead ECG recording closest to the OHCA event in bystander-witnessed OHCA patients. Among the 461 study patients, male sex (OR 2.54, 95% CI = 1.32–4.88, P = 0.005), age ≤ 65 years (OR 2.78, 95% CI = 1.64–4.70, P < 0.001), cardiovascular diseases (OR 2.97, 95% CI = 1.73–5.11, P < 0.001), and atrial fibrillation (AF) (OR 2.36, 95% CI = 1.17–4.76, P = 0.017) were independent risk factors for VT/VF OHCA (n = 81) compared with non-VT/VF OHCA (n = 380). A composite SACAF score was developed (male Sex, Age ≤ 65 years, Cardiovascular diseases, and AF) and compared with the performance of a modified CHA2DS2-VASc score (Cardiovascular diseases, Hypertension, Age ≥ 75 years, Diabetes, previous Stroke, Vascular disease, Age 65–74 years, female Sex category). The area under the receiver operating characteristic curve (AUC) of the SACAF was 0.739 (95% CI = 0.681–0.797, P < 0.001), whereas the AUC of the modified CHA2DS2-VASc was 0.474 (95% CI = 0.408–0.541, P = 0.464). A SACAF score of ≥ 2 was useful in discriminating VT/VF from non-VT/VF OHCAs with a sensitivity of 0.75 and a specificity of 0.60. In conclusion, the simple SACAF score appears to be useful in discriminating VT/VF from non-VT/VF bystander-witnessed OHCAs and the findings may also shed light on future mechanistic evaluation.Mei-Yao WuMing-Shien WenMien-Cheng ChenChia-Ti TsaiTsu-Juey WuWei-Chieh LeeYen-Nien LinShih-Sheng ChangKuan-Cheng ChangNature PortfolioarticleMedicineRScienceQENScientific Reports, Vol 11, Iss 1, Pp 1-9 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R Science Q
spellingShingle	Medicine R Science Q Mei-Yao Wu Ming-Shien Wen Mien-Cheng Chen Chia-Ti Tsai Tsu-Juey Wu Wei-Chieh Lee Yen-Nien Lin Shih-Sheng Chang Kuan-Cheng Chang Association of a simple SACAF score with bystander witnessed sudden death due to ventricular tachyarrhythmias in a multicenter cohort
description	Abstract Out-of-hospital cardiac arrest (OHCA) remains a major threat to public health worldwide. OHCA patients presenting initial shockable ventricular tachycardia/ventricular fibrillation (VT/VF) rhythm have a better survival rate. We sought to develop a simple SACAF score to discriminate VT/VF from non-VT/VF OHCAs based on the Taiwan multicenter hospital-based registry database. We analyzed the in- and pre-hospital data, including demographics, baseline comorbidities, response times, automated external defibrillator information, and the 12-lead ECG recording closest to the OHCA event in bystander-witnessed OHCA patients. Among the 461 study patients, male sex (OR 2.54, 95% CI = 1.32–4.88, P = 0.005), age ≤ 65 years (OR 2.78, 95% CI = 1.64–4.70, P < 0.001), cardiovascular diseases (OR 2.97, 95% CI = 1.73–5.11, P < 0.001), and atrial fibrillation (AF) (OR 2.36, 95% CI = 1.17–4.76, P = 0.017) were independent risk factors for VT/VF OHCA (n = 81) compared with non-VT/VF OHCA (n = 380). A composite SACAF score was developed (male Sex, Age ≤ 65 years, Cardiovascular diseases, and AF) and compared with the performance of a modified CHA2DS2-VASc score (Cardiovascular diseases, Hypertension, Age ≥ 75 years, Diabetes, previous Stroke, Vascular disease, Age 65–74 years, female Sex category). The area under the receiver operating characteristic curve (AUC) of the SACAF was 0.739 (95% CI = 0.681–0.797, P < 0.001), whereas the AUC of the modified CHA2DS2-VASc was 0.474 (95% CI = 0.408–0.541, P = 0.464). A SACAF score of ≥ 2 was useful in discriminating VT/VF from non-VT/VF OHCAs with a sensitivity of 0.75 and a specificity of 0.60. In conclusion, the simple SACAF score appears to be useful in discriminating VT/VF from non-VT/VF bystander-witnessed OHCAs and the findings may also shed light on future mechanistic evaluation.
format	article
author	Mei-Yao Wu Ming-Shien Wen Mien-Cheng Chen Chia-Ti Tsai Tsu-Juey Wu Wei-Chieh Lee Yen-Nien Lin Shih-Sheng Chang Kuan-Cheng Chang
author_facet	Mei-Yao Wu Ming-Shien Wen Mien-Cheng Chen Chia-Ti Tsai Tsu-Juey Wu Wei-Chieh Lee Yen-Nien Lin Shih-Sheng Chang Kuan-Cheng Chang
author_sort	Mei-Yao Wu
title	Association of a simple SACAF score with bystander witnessed sudden death due to ventricular tachyarrhythmias in a multicenter cohort
title_short	Association of a simple SACAF score with bystander witnessed sudden death due to ventricular tachyarrhythmias in a multicenter cohort
title_full	Association of a simple SACAF score with bystander witnessed sudden death due to ventricular tachyarrhythmias in a multicenter cohort
title_fullStr	Association of a simple SACAF score with bystander witnessed sudden death due to ventricular tachyarrhythmias in a multicenter cohort
title_full_unstemmed	Association of a simple SACAF score with bystander witnessed sudden death due to ventricular tachyarrhythmias in a multicenter cohort
title_sort	association of a simple sacaf score with bystander witnessed sudden death due to ventricular tachyarrhythmias in a multicenter cohort
publisher	Nature Portfolio
publishDate	2021
url	https://doaj.org/article/3ed25af173d542c089ef1bc0e2685371
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Association of a simple SACAF score with bystander witnessed sudden death due to ventricular tachyarrhythmias in a multicenter cohort

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