GO_FAR_Good_Outcome_Following_Attempted_Resuscitation_Score_guideline v.1

Age, Years

Neurologically intact or with minimal deficits at admission

Major trauma (injury associated with shock or altered mental status during current admission)

Acute stroke (ischemic or hemorrhagic stroke during current admission)

Metastatic or hematologic cancer

Septicemia (documented bloodstream infection with antibiotics not yet started or still ongoing)

Medical noncardiac diagnosis on admission

Hepatic insufficiency (total bilirubin >2 mg/dL or 34 µmol/L and AST >2x upper limit of normal, or cirrhosis)

Admit from skilled nursing facility

Hypotension or hypoperfusion within 4 hrs prior to arrest (SBP <90, MAP <60, pressors or inotropes other than dopamine ≤3 µmol/kg/min after volume expansion, or intra-aortic balloon pump)

Renal insufficiency or dialysis

Respiratory insufficiency within 4 hrs of arrest (any of the following: P/F ratio <300, PaO2 <60, SaO2 <90%; PaCO2, ETCO2, or transcutaneous CO2 >50, spontaneous RR >40 or <5, or noninvasive or invasive ventilation)

Pneumonia (documented active pneumonia with antibiotics not yet started or still ongoing)

Predicts survival to discharge with good outcome after in-hospital cardiac arrest.

Maryam Razavi

maryam.razavi2009@gmail.com

@CambioCDS

To develop a simple prearrest point score that can identify patients unlikely to survive IHCA, neurologically intact or with minimal deficits.

FORMULA Addition of the selected points, Variables and point: Age, years: <70=0, 70-74=2, 75-79=5, 80-84=6, ≥85=11. Neurologically intact or with minimal deficits at admission= -15 Major trauma (injury associated with shock or altered mental status during current admission)=10 Acute stroke (ischemic or hemorrhagic stroke during current admission)=8 Metastatic or hematologic cancer=7 Septicemia (documented bloodstream infection with antibiotics not yet started or still ongoing)=7 Medical noncardiac diagnosis on admission=7 Hepatic insufficiency (total bilirubin >2 mg/dL or 34 µmol/L and AST >2x upper limit of normal, or cirrhosis)=6 Admit from skilled nursing facility=6 Hypotension or hypoperfusion within 4 hrs prior to arrest (SBP <90, MAP <60, pressors or inotropes other than dopamine ≤3 µmol/kg/min after volume expansion, or intra-aortic balloon pump)=5 Renal insufficiency or dialysis=4 Respiratory insufficiency within 4 hrs of arrest (any of the following: P/F ratio <300, PaO2 <60, SaO2 <90%; PaCO2, ETCO2, or transcutaneous CO2 >50, spontaneous RR >40 or <5, or noninvasive or invasive ventilation)=4 Pneumonia (documented active pneumonia with antibiotics not yet started or still ongoing)=1 Interpretation: GO-FAR Score ≥24=Very low survival Risk group=<1% Survival to discharge with minimal neurologic disability GO-FAR Score 14 to 23=Low survival Risk group=1-3% Survival to discharge with minimal neurologic disability GO-FAR Score -5 to 13=Average survival Risk group=3-15% Survival to discharge with minimal neurologic disability GO-FAR Score -15 to -6=Above average survival Risk group=3-15% Survival to discharge with minimal neurologic disability

GO-FAR cannot be used in children and adult without experiencing an initial (index) episode of pulseless in-hospital cardiac arrest (IHCA).

1. Ebell MH, Jang W, Shen Y, Geocadin RG, for the Get With the Guidelines–Resuscitation Investigators. Development and Validation of the Good Outcome Following Attempted Resuscitation (GO-FAR) Score to Predict Neurologically Intact Survival After In-Hospital Cardiopulmonary Resuscitation. JAMA Intern Med. 2013;173(20):1872–1878. doi:10.1001/jamainternmed.2013.10037 2. Ajam, K., Gold, L. S., Beck, S. S., Damon, S., Phelps, R., and Rea, T. D. (2011). Reliability of the Cerebral Performance Category to classify neurological status among survivors of ventricular fibrillation arrest: a cohort study. Scandinavian journal of trauma, resuscitation and emergency medicine, 19, 38. https://doi.org/10.1186/1757-7241-19-38 3. D’Arrigo, S., Cacciola, S., Dennis, M., Jung, C., Kagawa, E., Antonelli, M., & Sandroni, C. (2017). Predictors of favourable outcome after in-hospital cardiac arrest treated with extracorporeal cardiopulmonary resuscitation: a systematic review and meta-analysis. Resuscitation, 121, 62-70.

OBSERVATION.go_far_good_outcome_following_attempted_resuscitation_score.v0, EVALUATION.go_far_good_outcome_following_attempted_resuscitation_score.v0

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