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Out-of-hospital cardiac arrest (OHCA) remains a major threat to public health worldwide. OHCA patients presenting initial shockable ventricular tachycardia/ventricular fibrillation (VT/VF) rhythm have a better survival rate. We sought to develop a simple SACAF score to discriminate VT/VF from non-VT/VF OHCAs based on the Taiwan multicenter hospital-based registry database. We analyzed the in- and pre-hospital data, including demographics, baseline comorbidities, response times, automated external defibrillator information, and the 12-lead ECG recording closest to the OHCA event in bystander-witnessed OHCA patients. Among the 461 study patients, male sex (OR 2.54, 95% CI = 1.32–4.88,  P  = 0.005), age ≤ 65 years (OR 2.78, 95% CI = 1.64–4.70,  P  < 0.001), cardiovascular diseases (OR 2.97, 95% CI = 1.73–5.11,  P  < 0.001), and atrial fibrillation (AF) (OR 2.36, 95% CI = 1.17–4.76,  P  = 0.017) were independent risk factors for VT/VF OHCA (n = 81) compared with non-VT/VF OHCA (n = 380). A composite SACAF score was developed (male  S ex,  A ge ≤ 65 years,  C ardiovascular diseases, and  AF ) and compared with the performance of a modified CHA 2 DS 2 -VASc score ( C ardiovascular diseases,  H ypertension,  A ge ≥ 75 years,  D iabetes, previous  S troke,  V ascular disease,  A ge 65–74 years, female  S ex  c ategory). The area under the receiver operating characteristic curve (AUC) of the SACAF was 0.739 (95% CI = 0.681–0.797,  P  < 0.001), whereas the AUC of the modified CHA 2 DS 2 -VASc was 0.474 (95% CI = 0.408–0.541,  P  = 0.464). A SACAF score of ≥ 2 was useful in discriminating VT/VF from non-VT/VF OHCAs with a sensitivity of 0.75 and a specificity of 0.60. In conclusion, the simple SACAF score appears to be useful in discriminating VT/VF from non-VT/VF bystander-witnessed OHCAs and the findings may also shed light on future mechanistic evaluation.

Association of a simple SACAF score with bystander witnessed sudden death due to ventricular tachyarrhythmias in a multicenter cohort