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    Patent Pending

    CART (Cardiac Arrest Risk Triage) Score

    Predicts risk of in-hospital cardiac arrest.
    Favorite
    Pearls/Pitfalls
    Why Use
    • A systematic review of early warning system (EWS) scores, including CART, concluded that such scores perform well to predict cardiac arrest but that impact on outcomes and resource utilization is still uncertain, and current evidence is insufficient (Smith 2014).
    • Requires accurate respiratory rate.
    • Predicting deterioration in ward patients may be difficult. Validated risk scores such as CART may help.
    • Outperformed MEWS at predicting cardiac arrest in one study (AUROC 0.84 vs 0.78) (Churpek 2013).
    <21
    0
    21-23
    +8
    24-25
    +12
    26-29
    +15
    >29
    +22
    <110
    0
    110-139
    +4
    >139
    +13
    >49
    0
    40-49
    +4
    35-39
    +6
    <35
    +13
    <55
    0
    55-69
    +4
    >69
    +9

    Result:

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    Next Steps
    Evidence
    Creator Insights

    Advice

    Patients with high CART Scores may benefit from escalation of care. Use clinical judgment in addition to risk stratification scores to make decisions related to disposition.

    Formula

    Addition of the selected points:

    Variable

    Points

    Respiratory rate, breaths/min

    <21

    0

    21-23

    8

    24-25

    12

    26-29

    15

    >29

    22

    Heart rate, beats/min

    <110

    0

    110-139

    4

    >139

    13

    Diastolic BP, mmHg

    >49

    0

    40-49

    4

    35-39

    6

    <35

    13

    Age, years

    <55

    0

    55-69

    4

    >69

    9

    Facts & Figures

    Interpretation:

    CART Score

    Risk of cardiac arrest within 48 hours

    ≤20

    Low

    >20

    High*

    *In the original study (Churpek 2012), scores >20 were 91.9% specific for predicting cardiac arrest within 48 hours, and 90% specific in a validation cohort (Churpek 2013).

    Dr. Matthew M. Churpek

    About the Creator

    Matthew M. Churpek, MD, PhD, MPH, is an assistant professor of medicine at the University of Chicago Medical Center. He has been awarded the American Heart Association Young Investigator Award. Dr. Churpek’s research focuses primarily on clinical prediction models, inpatient hospital deaths, and clinical deterioration.

    To view Dr. Matthew M. Churpek's publications, visit PubMed

    Dr. Dana Edelson

    About the Creator

    Dana Edelson, MD, is an assistant professor of hospital medicine at the University of Chicago. She is also the executive medical director for inpatient quality and safety. Dr. Edelson’s primary research is focused on prevention and treatment of in-hospital cardiac arrest.

    To view Dr. Dana Edelson's publications, visit PubMed