Comparison of return of spontaneous circulation prediction scores in patients with cardiac arrest during ambulance transport

Abstract Background Cardiac arrest during ambulance transport is a complex situation that has features of both in-hospital cardiac arrest (IHCA) and out-of-hospital cardiac arrest (OHCA) but lacks a clear classification. This study aimed to evaluate the diagnostic performance of prehospital and in-h...

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Main Authors: Neslihan Ergün Süzer, Gülbin Aydoğdu Umaç, Süleyman Alpar, Sarper Yılmaz
Format: Article
Language:English
Published: BMC 2025-07-01
Series:BMC Emergency Medicine
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Online Access:https://doi.org/10.1186/s12873-025-01265-1
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author Neslihan Ergün Süzer
Gülbin Aydoğdu Umaç
Süleyman Alpar
Sarper Yılmaz
author_facet Neslihan Ergün Süzer
Gülbin Aydoğdu Umaç
Süleyman Alpar
Sarper Yılmaz
author_sort Neslihan Ergün Süzer
collection DOAJ
description Abstract Background Cardiac arrest during ambulance transport is a complex situation that has features of both in-hospital cardiac arrest (IHCA) and out-of-hospital cardiac arrest (OHCA) but lacks a clear classification. This study aimed to evaluate the diagnostic performance of prehospital and in-hospital ROSC prediction tools in patients experiencing cardiac arrest during ambulance transport. Methods A retrospective study was conducted with patients experiencing cardiac arrest during transport. Demographic, clinical, and treatment data were collected, including pre-arrest consciousness, arrest rhythm, and cardiopulmonary resuscitation duration. Four ROSC prediction scores (Prehospital-ROSC, the ROSC after cardiac arrest, Utstein-Based ROSC, and The Cardiac Arrest Survival Post-Resuscitation In-Hospital scores) were used to assess the patients. The AUROCs of the scores were compared to evaluate their diagnostic accuracy. Results Patients were categorized into two groups based on ROSC: No-ROSC (n = 248, 75.2%) and ROSC (n = 82, 24.8%). The ROSC group had significantly more shockable rhythms (81.7% vs. 22.2%, p < 0.001) and a higher proportion of cardiac etiology (p = 0.015) compared to the No-ROSC group. The time for the ambulance to reach the patient did not significantly differ between groups (p = 0.140), but the time spent in the ambulance before arrest was significantly shorter in the ROSC group (p = 0.026). The prehospital-ROSC score had the highest diagnostic performance (AUROC 0.791), followed by The ROSC after cardiac arrest score (0.754) and The Utstein-Based ROSC score (0.716). The Cardiac Arrest Survival Post-Resuscitation In-Hospital score had the lowest performance (0.658). Prehospital-ROSC score outperformed the Utstein-Based ROSC score (p = 0.005), and the Cardiac Arrest Survival Post-Resuscitation In-Hospital score was significantly lower than both ROSC after cardiac arrest score (p = 0.031) and the prehospital-ROSC score (p < 0.001). Conclusion Prehospital-ROSC score was the most accurate predictor of ROSC in patients experiencing cardiac arrest during ambulance transport, while the Cardiac Arrest Survival Post-Resuscitation In-Hospital score demonstrated lower predictive accuracy.
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spelling doaj-art-cf88db8d02954976b2c8f977a9901c052025-08-20T03:37:23ZengBMCBMC Emergency Medicine1471-227X2025-07-0125111110.1186/s12873-025-01265-1Comparison of return of spontaneous circulation prediction scores in patients with cardiac arrest during ambulance transportNeslihan Ergün Süzer0Gülbin Aydoğdu Umaç1Süleyman Alpar2Sarper Yılmaz3Department of Emergency Medicine, Kocaeli Darıca Farabi Training and Research HospitalDepartment of Emergency Medicine, İzmir City HospitalFaculty of Medicine, İstanbul Beykent UniversityDepartment of Emergency Medicine, Kartal Dr. Lutfi Kirdar City Hospital, University of Health SciencesAbstract Background Cardiac arrest during ambulance transport is a complex situation that has features of both in-hospital cardiac arrest (IHCA) and out-of-hospital cardiac arrest (OHCA) but lacks a clear classification. This study aimed to evaluate the diagnostic performance of prehospital and in-hospital ROSC prediction tools in patients experiencing cardiac arrest during ambulance transport. Methods A retrospective study was conducted with patients experiencing cardiac arrest during transport. Demographic, clinical, and treatment data were collected, including pre-arrest consciousness, arrest rhythm, and cardiopulmonary resuscitation duration. Four ROSC prediction scores (Prehospital-ROSC, the ROSC after cardiac arrest, Utstein-Based ROSC, and The Cardiac Arrest Survival Post-Resuscitation In-Hospital scores) were used to assess the patients. The AUROCs of the scores were compared to evaluate their diagnostic accuracy. Results Patients were categorized into two groups based on ROSC: No-ROSC (n = 248, 75.2%) and ROSC (n = 82, 24.8%). The ROSC group had significantly more shockable rhythms (81.7% vs. 22.2%, p < 0.001) and a higher proportion of cardiac etiology (p = 0.015) compared to the No-ROSC group. The time for the ambulance to reach the patient did not significantly differ between groups (p = 0.140), but the time spent in the ambulance before arrest was significantly shorter in the ROSC group (p = 0.026). The prehospital-ROSC score had the highest diagnostic performance (AUROC 0.791), followed by The ROSC after cardiac arrest score (0.754) and The Utstein-Based ROSC score (0.716). The Cardiac Arrest Survival Post-Resuscitation In-Hospital score had the lowest performance (0.658). Prehospital-ROSC score outperformed the Utstein-Based ROSC score (p = 0.005), and the Cardiac Arrest Survival Post-Resuscitation In-Hospital score was significantly lower than both ROSC after cardiac arrest score (p = 0.031) and the prehospital-ROSC score (p < 0.001). Conclusion Prehospital-ROSC score was the most accurate predictor of ROSC in patients experiencing cardiac arrest during ambulance transport, while the Cardiac Arrest Survival Post-Resuscitation In-Hospital score demonstrated lower predictive accuracy.https://doi.org/10.1186/s12873-025-01265-1Out-of-hospital cardiac arrestCardiac arrest prediction modelsReturn of spontaneous circulationEmergency medical services
spellingShingle Neslihan Ergün Süzer
Gülbin Aydoğdu Umaç
Süleyman Alpar
Sarper Yılmaz
Comparison of return of spontaneous circulation prediction scores in patients with cardiac arrest during ambulance transport
BMC Emergency Medicine
Out-of-hospital cardiac arrest
Cardiac arrest prediction models
Return of spontaneous circulation
Emergency medical services
title Comparison of return of spontaneous circulation prediction scores in patients with cardiac arrest during ambulance transport
title_full Comparison of return of spontaneous circulation prediction scores in patients with cardiac arrest during ambulance transport
title_fullStr Comparison of return of spontaneous circulation prediction scores in patients with cardiac arrest during ambulance transport
title_full_unstemmed Comparison of return of spontaneous circulation prediction scores in patients with cardiac arrest during ambulance transport
title_short Comparison of return of spontaneous circulation prediction scores in patients with cardiac arrest during ambulance transport
title_sort comparison of return of spontaneous circulation prediction scores in patients with cardiac arrest during ambulance transport
topic Out-of-hospital cardiac arrest
Cardiac arrest prediction models
Return of spontaneous circulation
Emergency medical services
url https://doi.org/10.1186/s12873-025-01265-1
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AT suleymanalpar comparisonofreturnofspontaneouscirculationpredictionscoresinpatientswithcardiacarrestduringambulancetransport
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