GO-FAR (Good Outcome Following Attempted Resuscitation) Score

GO-FAR Score
Neurologically Intact at Admission
Major Trauma
Acute Stroke
Metastatic or Hematologic Malignancy
Septicemia
Medical Noncardiac Diagnosis
Hepatic Insufficiency
Admit from Skilled Nursing Facility
Hypotension / Hypoperfusion
Renal Insufficiency / Dialysis
Respiratory Insufficiency
Pneumonia
Age
GO-FAR Score: 0
Above Average Survival
Score ≤0: Above average survival to discharge with good neurologic outcome.
Predicts survival to discharge with good outcome after in-hospital cardiac arrest.

Why Use

Patients and families sometimes have unrealistic expectations of quality of life after surviving in-hospital cardiac arrest. The GO-FAR Score may help in discussions regarding code status and prognosis.

Formula

Addition of the selected points: Variable Points Age, years <70 0 70-74 2 75-79 5 80-84 6 ≥85 11 Neurologically intact or with minimal deficits at admission -15 Major trauma (injury associated with shock or altered mental status during current admission) 10 Acute stroke (ischemic or hemorrhagic stroke during current admission) 8 Metastatic or hematologic cancer 7 Septicemia (documented bloodstream infection with antibiotics not yet started or still ongoing) 7 Medical noncardiac diagnosis on admission 7 Hepatic insufficiency (total bilirubin >2 mg/dL or 34 µmol/L and AST >2x upper limit of normal, or cirrhosis) 6 Admit from skilled nursing facility 6 Hypotension or hypoperfusion within 4 hrs prior to arrest (SBP <90, MAP <60, pressors or inotropes other than dopamine ≤3 µmol/kg/min after volume expansion, or intra-aortic balloon pump) 5 Renal insufficiency or dialysis 4 Respiratory insufficiency within 4 hrs of arrest (any of the following: P/F ratio <300, PaO 2 <60, SaO 2 <90%; PaCO 2 , ETCO 2 , or transcutaneous CO 2 >50, spontaneous RR >40 or <5, or noninvasive or invasive ventilation) 4 Pneumonia (documented active pneumonia with antibiotics not yet started or still ongoing) 1

Pearls / Pitfalls

Derived on registry-based data split into derivation and validation sets.

Advice

Consider patient preferences and general medical prognosis in discussions of code status and aggressiveness of interventions.

More Information

Interpretation: GO-FAR Score Risk group Survival to discharge with minimal neurologic disability* ≥24 Very low survival <1% 14 to 23 Low survival 1-3% -5 to 13 Average survival 3-15% -15 to -6 Above average survival >15% *Defined as cerebral performance category of 1 or good cerebral performance (patient is conscious, alert, and able to work but might have mild neurologic or psychological deficits, such as mild dysphagia or minor cranial nerve abnormalities).

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