Potpara, Tatjana S. (57216792589)Tatjana S. (57216792589)PotparaMihajlovic, Miroslav (57207498211)Miroslav (57207498211)MihajlovicStankovic, Sanja (7005216636)Sanja (7005216636)StankovicJozic, Tanja (6504760115)Tanja (6504760115)JozicJozic, Irena (57195197364)Irena (57195197364)JozicAsanin, Milika R. (8603366900)Milika R. (8603366900)AsaninAhmad, Rajai (23990255500)Rajai (23990255500)AhmadLip, Gregory Y.H. (57216675273)Gregory Y.H. (57216675273)Lip2025-06-122025-06-122017https://doi.org/10.1016/j.amjmed.2017.05.035https://www.scopus.com/inward/record.uri?eid=2-s2.0-85026193452&doi=10.1016%2fj.amjmed.2017.05.035&partnerID=40&md5=f53c4814e8821048240914f52282f2bchttps://remedy.med.bg.ac.rs/handle/123456789/6696Background Rapid clinical decision-making on further management of patients with out-of-hospital cardiac arrest may be challenging. Recently, a “futility” score (NULL-PLEASE) incorporating multiple adverse resuscitation features (Nonshockable rhythm, Unwitnessed arrest, Long no-flow or Long low-flow period, blood PH <7.2, Lactate >7.0 mmol/L, End-stage chronic kidney disease on dialysis, Age ≥85 years, Still resuscitation, and Extracardiac cause) has been proposed to help identify patients with out-of-hospital cardiac arrest unlikely to survive; however, external independent score validation is lacking. Methods We retrospectively validated the NULL-PLEASE predictive ability for early in-hospital outcome of out-of-hospital cardiac arrest in a single-center cohort of 547 consecutive patients with out-of-hospital cardiac arrest who were admitted from April 2013 to October 2016 (mean age, 66.3 ± 13.2 years); 227 patients (41.5%) died. Because pH and lactate were inconsistently measured, a modified NULL-PLEASE score excluding both variables was calculated as the principal analysis. A sensitivity analysis included the subgroup with pH data available (n = 177). Results Long low-flow period and age ≥85 years were independently associated with fatal outcome (both P <.001). Patients with a modified NULL-PLEASE score of ≥5 had a 3.3-fold greater risk of fatal outcome compared with a score of 0 to 4 (odds ratio, 3.34; 95% confidence interval [CI], 2.29-4.89; P <.001); 77% of nonsurvivors had a score ≥5; NULL-PLEASE showed a modest predictive ability for fatal outcome (c-statistic 0.658; 95% CI, 0.613-0.704; P <.001). Sensitivity analysis yielded similar results, with 88% of nonsurvivors having a score ≥5. Conclusions The NULL-PLEASE score was predictive for early in-hospital outcome of out-of-hospital cardiac arrest, with a 3.3-fold greater odds for fatal outcome at the score values of ≥5. © 2017 Elsevier Inc.In-hospital mortalityNULL-PLEASE scoreOut-of-hospital cardiac arrestOutcomePredictionResuscitation