PMID- 28993178
OWN - NLM
STAT- MEDLINE
DCOM- 20180720
LR  - 20191210
IS  - 1873-1570 (Electronic)
IS  - 0300-9572 (Linking)
VI  - 121
DP  - 2017 Dec
TI  - A user-friendly risk-score for predicting in-hospital cardiac arrest among 
      patients admitted with suspected non ST-elevation acute coronary syndrome - The 
      SAFER-score.
PG  - 41-48
LID - S0300-9572(17)30653-6 [pii]
LID - 10.1016/j.resuscitation.2017.10.004 [doi]
AB  - AIM: To develop a simple risk-score model for predicting in-hospital cardiac 
      arrest (CA) among patients hospitalized with suspected non-ST elevation acute 
      coronary syndrome (NSTE-ACS). METHODS: Using the Swedish Web-system for 
      Enhancement and Development of Evidence-based care in Heart disease Evaluated 
      According to Recommended Therapies (SWEDEHEART), we identified patients (n=242 
      303) admitted with suspected NSTE-ACS between 2008 and 2014. Logistic regression 
      was used to assess the association between 26 candidate variables and in-hospital 
      CA. A risk-score model was developed and validated using a temporal cohort (n=126 
      073) comprising patients from SWEDEHEART between 2005 and 2007 and an external 
      cohort (n=276 109) comprising patients from the Myocardial Ischaemia National 
      Audit Project (MINAP) between 2008 and 2013. RESULTS: The incidence of 
      in-hospital CA for NSTE-ACS and non-ACS was lower in the SWEDEHEART-derivation 
      cohort than in MINAP (1.3% and 0.5% vs. 2.3% and 2.3%). A seven point, five 
      variable risk score (age >/=60 years (1 point), ST-T abnormalities (2 points), 
      Killip Class >1 (1 point), heart rate <50 or >/=100bpm (1 point), and systolic 
      blood pressure <100mmHg (2 points) was developed. Model discrimination was good 
      in the derivation cohort (c-statistic 0.72) and temporal validation cohort 
      (c-statistic 0.74), and calibration was reasonable with a tendency towards 
      overestimation of risk with a higher sum of score points. External validation 
      showed moderate discrimination (c-statistic 0.65) and calibration showed a 
      general underestimation of predicted risk. CONCLUSIONS: A simple points score 
      containing five variables readily available on admission predicts in-hospital CA 
      for patients with suspected NSTE-ACS.
CI  - Copyright (c) 2017 Elsevier B.V. All rights reserved.
FAU - Faxen, Jonas
AU  - Faxen J
AD  - Department of Medicine, Karolinska Institutet and Department of Cardiology, 
      Karolinska University Hospital Stockholm, Sweden. Electronic address: 
      jonas.faxen@sll.se.
FAU - Hall, Marlous
AU  - Hall M
AD  - Leeds Institute of Cardiovascular and Metabolic Medicine, University of Leeds, 
      Leeds, UK.
FAU - Gale, Chris P
AU  - Gale CP
AD  - Leeds Institute of Cardiovascular and Metabolic Medicine, University of Leeds, 
      Leeds, UK; York Teaching Hospital NHS Foundation Trust, York, UK.
FAU - Sundstrom, Johan
AU  - Sundstrom J
AD  - Department of Medical Sciences, Uppsala University Hospital, Uppsala, Sweden.
FAU - Lindahl, Bertil
AU  - Lindahl B
AD  - Uppsala Clinical Research Centre, University of Uppsala, Uppsala, Sweden.
FAU - Jernberg, Tomas
AU  - Jernberg T
AD  - Department of Clinical Sciences, Danderyd University Hospital, Karolinska 
      Institutet, Stockholm, Sweden.
FAU - Szummer, Karolina
AU  - Szummer K
AD  - Department of Medicine, Karolinska Institutet and Department of Cardiology, 
      Karolinska University Hospital Stockholm, Sweden.
LA  - eng
PT  - Journal Article
PT  - Validation Study
DEP - 20171006
PL  - Ireland
TA  - Resuscitation
JT  - Resuscitation
JID - 0332173
SB  - IM
CIN - Resuscitation. 2018 Aug;129:e9. PMID: 29894699
CIN - Resuscitation. 2018 Jul;128:e1-e2. PMID: 29907378
MH  - Acute Coronary Syndrome/*epidemiology/physiopathology
MH  - Aged
MH  - Aged, 80 and over
MH  - Case-Control Studies
MH  - Electrocardiography
MH  - Evidence-Based Medicine/methods
MH  - Female
MH  - Heart Arrest/*epidemiology/etiology
MH  - Hospital Mortality
MH  - Humans
MH  - Incidence
MH  - Male
MH  - Middle Aged
MH  - Registries
MH  - Risk Assessment
MH  - Risk Factors
OTO - NOTNLM
OT  - Acute coronary syndrome
OT  - In-hospital cardiac arrest
OT  - Non-ST elevation acute coronary syndrome
OT  - Risk score
OT  - Risk stratification
EDAT- 2017/10/11 06:00
MHDA- 2018/07/22 06:00
CRDT- 2017/10/11 06:00
PHST- 2017/05/09 00:00 [received]
PHST- 2017/09/10 00:00 [revised]
PHST- 2017/10/04 00:00 [accepted]
PHST- 2017/10/11 06:00 [pubmed]
PHST- 2018/07/22 06:00 [medline]
PHST- 2017/10/11 06:00 [entrez]
AID - S0300-9572(17)30653-6 [pii]
AID - 10.1016/j.resuscitation.2017.10.004 [doi]
PST - ppublish
SO  - Resuscitation. 2017 Dec;121:41-48. doi: 10.1016/j.resuscitation.2017.10.004. Epub 
      2017 Oct 6.