Identifying Patients at Risk for Prehospital Sudden Cardiac Arrest at the Early Phase of Myocardial Infarction: The e-MUST Study (Evaluation en Médecine d'Urgence des Stratégies Thérapeutiques des infarctus du myocarde)
Authors' conclusion
At the early phase of STEMI, the risk of prehospital SCA can be determined through a simple score of 5 routinely assessed predictors.
Study context
- Population
- Patients with STEMI managed by emergency medical services in the greater Paris area, 2006–2010median age 60 y
- Participants
- 8,112 patients
- Exposure
- Sudden cardiac arrest (SCA) prediction score categories
- Outcome
- Prehospital SCA
Methodological detailsinternal and external validation
- Internal and external validation
Main finding
As reported in the abstract
Prehospital SCA by prediction score
- Overall SCA (n=8112)
- 452 (5.6%)
- Risk vs score <10: score 10–19
- 2-fold
- Risk vs score <10: score 20–29
- 4-fold
- Risk vs score <10: score ≥30
- >18-fold
- SCA rate score ≥30 vs ≤9, P for trend
- <0.001
- AUC, internal validation
- 0.7033
- AUC, external validation
- 0.6031
- Sensitivity / specificity, scores ≥10
- 96.9% / 10.5%
- Sensitivity / specificity, scores ≥30
- 18.0% / 97.6%
- Sensitivity / specificity, scores 20–29 (best)
- 65.4% / 62.6%
Observational data: associations, not effects.
Original publication
Identifying Patients at Risk for Prehospital Sudden Cardiac Arrest at the Early Phase of Myocardial Infarction: The e-MUST Study (Evaluation en Médecine d'Urgence des Stratégies Thérapeutiques des infarctus du myocarde). Circulation. Published 28 October 2016. doi:10.
Summarised from the published abstract; every number is checked against it