Reply to Letter: The importance of comorbidity and illness severity scores in cardiac arrest research

Reply to Letter: The importance of comorbidity and illness severity scores in cardiac arrest research

Resuscitation 102 (2016) e4 Contents lists available at ScienceDirect Resuscitation journal homepage: www.elsevier.com/locate/resuscitation Reply t...

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Resuscitation 102 (2016) e4

Contents lists available at ScienceDirect

Resuscitation journal homepage: www.elsevier.com/locate/resuscitation

Reply to Letter to the Editor Reply to Letter: The importance of comorbidity and illness severity scores in cardiac arrest research

that cannot be used to evaluate chances of (a neurologic favorable) outcome before the OHCA occurred. Conflict of interest statement

Sir, None declared. We read with interest the comment made by Dr. Fouche on our study on comorbidity and favorable neurologic outcome after outof-hospital cardiac arrest (OHCA) in patients of 70 years and older. We agree with Dr. Fouche that co-morbidities may have a significant impact on mortality. Using the Charlson Comorbidity Index (CCI) as a binary variable may indeed have its limitations when predicting outcome after OHCA. Dr. Fouche suggests adjusting for the Pittsburgh Cardiac Arrest Category (PCAC) illness severity score when studying outcome. The PCAC is highly predictive of survival after OHCA. However, the main focus of our study was to evaluate factors that can actually be discussed by the general practitioner or treating physician with the patient in the context of advance care planning. The PCAC score is determined in hospital, after the cardiac arrest took place. Therefore, we regard the PCAC score as a result of the cardiac arrest

DOI of original article: http://dx.doi.org/10.1016/j.resuscitation.2016.01.035. http://dx.doi.org/10.1016/j.resuscitation.2016.02.028 0300-9572/© 2016 Elsevier Ireland Ltd. All rights reserved.

S.G. Beesems ∗ M.T. Blom M. Hulleman R.W. Koster Department of Cardiology, Academic Medical Center, University of Amsterdam, University of Amsterdam, P.O. Box 22660, 1100 DD Amsterdam, The Netherlands ∗ Corresponding

author. E-mail address: [email protected] (S.G. Beesems) 19 February 2016