P-ROSC, UB-ROSC, and RACA Scores in Predicting the Return of Spontaneous Circulation in Out-of-hospital Cardiac Arrest: A Retrospective Cohort

Introduction: Prehospital Return of Spontaneous Circulation (P-ROSC), Utstein-Based Return of Spontaneous Circulation (UB-ROSC), and Return of Spontaneous Circulation After Cardiac Arrest (RACA) scores have been developed to estimate the likelihood of Return of Spontaneous Circulation (ROSC) in Out...

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Main Authors: Tanakorn Janbavonkij, Chaiyaporn Yuksen, Kasamon Aramvanitch, Pitsucha Sanguanwit, Thanakorn Laksanamapune, Chetsadakon Jenpanitpong, Thavinee Trainarongsakul, Suteenun Seesuklom
Format: Article
Language:English
Published: Shahid Beheshti University of Medical Sciences 2025-03-01
Series:Archives of Academic Emergency Medicine
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Online Access:https://journals.sbmu.ac.ir/aaem/index.php/AAEM/article/view/2631
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author Tanakorn Janbavonkij
Chaiyaporn Yuksen
Kasamon Aramvanitch
Pitsucha Sanguanwit
Thanakorn Laksanamapune
Chetsadakon Jenpanitpong
Thavinee Trainarongsakul
Suteenun Seesuklom
author_facet Tanakorn Janbavonkij
Chaiyaporn Yuksen
Kasamon Aramvanitch
Pitsucha Sanguanwit
Thanakorn Laksanamapune
Chetsadakon Jenpanitpong
Thavinee Trainarongsakul
Suteenun Seesuklom
author_sort Tanakorn Janbavonkij
collection DOAJ
description Introduction: Prehospital Return of Spontaneous Circulation (P-ROSC), Utstein-Based Return of Spontaneous Circulation (UB-ROSC), and Return of Spontaneous Circulation After Cardiac Arrest (RACA) scores have been developed to estimate the likelihood of Return of Spontaneous Circulation (ROSC) in Out-of-hospital cardiac arrest (OHCA). This study aimed to validate and compare these three scoring systems. Methods: A retrospective cohort study was conducted using electronic medical records of OHCA patients transported by Ramathibodi Emergency Medical Service (EMS) from January 2021 to October 2024. We included all OHCA patients aged >18 years who transported by Ramathibodi EMS. RACA, UB-ROSC, and P-ROSC scores were calculated, and ROSC was recorded. The area under the ROC curve (AUC) of each score were calculated to assess predictive accuracy. Results: Among 336 OHCA cases, 94 (27.97%) patients achieved ROSC. The RACA score demonstrated the highest predictive accuracy, with an AUC of 0.77 (95% CI: 0.71–0.82). The UB-ROSC score followed with an AUC of 0.72 (95% CI: 0.66–0.78), while the P-ROSC score had the lowest predictive value with an AUC of 0.64 (95% CI: 0.58–0.70). Calibration analysis indicated that the RACA score aligned most closely with observed outcomes compared to the UB-ROSC and P-ROSC scores. The RACA score exhibited the best overall performance in terms of both discrimination and calibration. Conclusions: Among the three predictive models assessed, the RACA and UB-ROSC scores demonstrated fair predictive accuracy for ROSC in OHCA patients, while the P-ROSC score had poor predictive value.
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spelling doaj-art-60449b8643714c8a9a6d4c61acaaae832025-08-20T03:40:00ZengShahid Beheshti University of Medical SciencesArchives of Academic Emergency Medicine2645-49042025-03-0113110.22037/aaemj.v13i1.2631P-ROSC, UB-ROSC, and RACA Scores in Predicting the Return of Spontaneous Circulation in Out-of-hospital Cardiac Arrest: A Retrospective Cohort Tanakorn JanbavonkijChaiyaporn Yuksen0Kasamon AramvanitchPitsucha SanguanwitThanakorn LaksanamapuneChetsadakon JenpanitpongThavinee TrainarongsakulSuteenun SeesuklomRamathibodi hospital Introduction: Prehospital Return of Spontaneous Circulation (P-ROSC), Utstein-Based Return of Spontaneous Circulation (UB-ROSC), and Return of Spontaneous Circulation After Cardiac Arrest (RACA) scores have been developed to estimate the likelihood of Return of Spontaneous Circulation (ROSC) in Out-of-hospital cardiac arrest (OHCA). This study aimed to validate and compare these three scoring systems. Methods: A retrospective cohort study was conducted using electronic medical records of OHCA patients transported by Ramathibodi Emergency Medical Service (EMS) from January 2021 to October 2024. We included all OHCA patients aged >18 years who transported by Ramathibodi EMS. RACA, UB-ROSC, and P-ROSC scores were calculated, and ROSC was recorded. The area under the ROC curve (AUC) of each score were calculated to assess predictive accuracy. Results: Among 336 OHCA cases, 94 (27.97%) patients achieved ROSC. The RACA score demonstrated the highest predictive accuracy, with an AUC of 0.77 (95% CI: 0.71–0.82). The UB-ROSC score followed with an AUC of 0.72 (95% CI: 0.66–0.78), while the P-ROSC score had the lowest predictive value with an AUC of 0.64 (95% CI: 0.58–0.70). Calibration analysis indicated that the RACA score aligned most closely with observed outcomes compared to the UB-ROSC and P-ROSC scores. The RACA score exhibited the best overall performance in terms of both discrimination and calibration. Conclusions: Among the three predictive models assessed, the RACA and UB-ROSC scores demonstrated fair predictive accuracy for ROSC in OHCA patients, while the P-ROSC score had poor predictive value. https://journals.sbmu.ac.ir/aaem/index.php/AAEM/article/view/2631return of spontaneous circulationCardiac Arrestclinical predictionPrehospitalAmbulance
spellingShingle Tanakorn Janbavonkij
Chaiyaporn Yuksen
Kasamon Aramvanitch
Pitsucha Sanguanwit
Thanakorn Laksanamapune
Chetsadakon Jenpanitpong
Thavinee Trainarongsakul
Suteenun Seesuklom
P-ROSC, UB-ROSC, and RACA Scores in Predicting the Return of Spontaneous Circulation in Out-of-hospital Cardiac Arrest: A Retrospective Cohort
Archives of Academic Emergency Medicine
return of spontaneous circulation
Cardiac Arrest
clinical prediction
Prehospital
Ambulance
title P-ROSC, UB-ROSC, and RACA Scores in Predicting the Return of Spontaneous Circulation in Out-of-hospital Cardiac Arrest: A Retrospective Cohort
title_full P-ROSC, UB-ROSC, and RACA Scores in Predicting the Return of Spontaneous Circulation in Out-of-hospital Cardiac Arrest: A Retrospective Cohort
title_fullStr P-ROSC, UB-ROSC, and RACA Scores in Predicting the Return of Spontaneous Circulation in Out-of-hospital Cardiac Arrest: A Retrospective Cohort
title_full_unstemmed P-ROSC, UB-ROSC, and RACA Scores in Predicting the Return of Spontaneous Circulation in Out-of-hospital Cardiac Arrest: A Retrospective Cohort
title_short P-ROSC, UB-ROSC, and RACA Scores in Predicting the Return of Spontaneous Circulation in Out-of-hospital Cardiac Arrest: A Retrospective Cohort
title_sort p rosc ub rosc and raca scores in predicting the return of spontaneous circulation in out of hospital cardiac arrest a retrospective cohort
topic return of spontaneous circulation
Cardiac Arrest
clinical prediction
Prehospital
Ambulance
url https://journals.sbmu.ac.ir/aaem/index.php/AAEM/article/view/2631
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