Andjelic, Sladjana (35791554900)Sladjana (35791554900)AndjelicPjevic, Miroslava (18337021600)Miroslava (18337021600)PjevicVasiljevic, Zorana (6602641182)Zorana (6602641182)VasiljevicSijacki, Ana (35460103000)Ana (35460103000)SijackiIvancevic, Nenad (24175884900)Nenad (24175884900)Ivancevic2025-06-122025-06-122012https://www.scopus.com/inward/record.uri?eid=2-s2.0-84892038278&partnerID=40&md5=4040583735d5e09ebd434fc49b9f346chttps://remedy.med.bg.ac.rs/handle/123456789/9528Introduction: A large numbers of patients who are resuscitated in out-of-hospital settings are not admitted or discharged from the hospital, for one year after cardiac arrest. Objective: The aim of this research was to evaluate immediate (return of spontaneous circulation - ROSC >24), short-term (until discharge from hospital) and long-term (12 months after arrest) survival of patients who underwent out-of-hospital cardiopulmonary resuscitation (CPR) by using Resuscitation Prediction Scoring (RPS), Advanced Cardiac Life Support (ACLS) and Early Prediction Score (EPS), as well as identification of individual outcome predictors and development of new prediction scores. Methods: A prospective, two-year, multicentric study (conducted in Belgrade, Novi Sad, Nis, and Kragujevac) was used to evaluate outcomes of out-of-hospital CPR in the following groups: Group 1 - CPR within 4 minutes from arrest; Group 2 - CPR 4 minutes after arrest (survival or death). Emergency Medical Service (EMS) team (physician, technician and driver) conducted CPR according to ERC ALS algorithm from 2005. The research instruments were Utstein Template, RPS, ACLS, and EPS. The first batch of results consists of descriptive presentation of Utstein variables obtained by univariate analysis, while second batch represents ROC analysis using RPS, ACLS and EPS. New SRQOL (i,s,l) numeric models have been created by identifying risk factors (p<0.05), as well as by using successive-logistic and linear-regression method. Results: Out of a total number of patients (n=591), 27.2% were assigned to Group 1 - CPR within 4 minutes from arrest, while 62.8% were assigned to Group 2, accompanied by a significant difference in survival (p<0.001). The predictive ability of the RPS scale in Group 1 (ROC=0.691) was poor, while in Group 2 (ROC=0.704) it was satisfying; the ACLS score in Group 1 (ROC=0.850) was good, while in Group 2 (ROC=0.630) it was poor; the EPS score (ROC=0.823) in both Groups 1 and 2 (ROC=0.821) was good. Univariate variables were: younger age, arrest developed in front of EMS team, laymen CPR, cardiac cause of arrest, CT/VF rhythm, initially responsive pupils, initial swallowing reflex, and early professional CPR (CPR within 4 minutes). SR-QOL survival prediction models have been created. SR-QOLi (ROC=0.833) and SR-QOLs (ROC=0,882) represent good models for prediction of immediate and short-term survival, respectively. SR-QOLl (ROC=0.913) is an excellent model for prediction of long-term survival. Cumulative survival of our patients by evaluated time points was: ROSC: 12.7%; until discharge from hospital: 11.3%, and until 12 months: 10.0%. Conclusion: The research created SR-QOL models for prediction of immediate (SR-QOLi), short-term (SR-QOLs) and long-term (SRQOLl) survival after out-of-hospital CPR, which are characterized by their superior prediction ability in local settings compared to standard scores (RPS, ACLS and EPS). Further investigations and evaluations of validity are needed in order to enhance their predictive value. © 2012 Nova Science Publishers, Inc.