AIMS: Survival after out-of-hospital cardiac arrest (OHCA) remains 
disappointingly low. Among patients admitted alive, early prognostication 
remains challenging. This study aims to establish a stratification score for 
patients admitted in intensive care unit (ICU) after OHCA, according to their 
neurological outcome.
METHODS AND RESULTS: The CAHP (Cardiac Arrest Hospital Prognosis) score was 
developed from the Sudden Death Expertise Center registry (Paris, France). The 
primary outcome was poor neurological outcome defined as Cerebral Performance 
Category 3, 4, or 5 at hospital discharge. Independent prognostic factors were 
identified using logistic regression analysis and thresholds defined to stratify 
low-, moderate-, and high-risk groups. The CAHP score was validated in both a 
prospective and an external data set (Parisian Cardiac Arrest Registry). The 
developmental data set included 819 patients admitted from May 2011 to December 
2012. After multivariate analysis, seven variables were independently associated 
with poor neurological outcome and subsequently included in the CAHP score (age, 
non-shockable rhythm, time from collapse to basic life support, time from basic 
life support to return of spontaneous circulation, location of cardiac arrest, 
epinephrine dose, and arterial pH). Three risks groups were identified: low risk 
(score ≤150, 39% of unfavourable outcome), medium risk (score 150-200, 81% of 
unfavourable outcome) and high-risk group (score ≥200, 100% of unfavourable 
outcome). The AUC of the CAHP score were 0.93, and the discrimination value in 
the validation data sets was consistent (respectively, AUC 0.91 and 0.85).
CONCLUSION: The CAHP score represents a simple tool for early stratification of 
patients admitted in ICU after OHCA. A high-risk category of patients with very 
poor prognosis can be easily identified.