Identifying individuals satisfying the termination of resuscitation rule but having potential to achieve favourable neurological outcome following out-of-hospital cardiac arrest
Copyright © 2023 Elsevier B.V. All rights reserved..
AIM: To develop a simple scoring model that identifies individuals satisfying the termination of resuscitation (TOR) rule but having potential to achieve favourable neurological outcome following out-of-hospital cardiac arrest (OHCA).
METHODS: This study analysed the All-Japan Utstein Registry from 1 January 2010 to 31 December 2019. We identified patients satisfying basic life support (BLS) and advanced life support (ALS) TOR rules and determined factors associated with favourable neurological outcome (cerebral performance category scale of 1 or 2) for each cohort using multivariable logistic regression analysis. Scoring models were derived and validated to identify patient subgroups that might benefit from continued resuscitation efforts.
RESULTS: Among 1,695,005 eligible patients, 1,086,092 (64.1%) and 409,498 (24.2%) satisfied BLS and ALS TOR rules, respectively. One month post-arrest, 2038 (0.2%) and 590 (0.1%) patients in the BLS and ALS cohorts, respectively, achieved favourable neurological outcome. A scoring model derived for the BLS cohort (2 points for age <17 years or ventricular fibrillation/ventricular tachycardia rhythm; 1 point for age <80 years, pulseless electrical activity rhythm, or transport time <25 min) effectively stratified the probability of achieving 1-month favourable neurological outcome, with patients scoring <4 having a probability of <1%, whereas those scoring 4, 5, and 6 having probabilities of 1.1%, 7.1%, and 11.1%, respectively. In the ALS cohort, the probability increased with scores; however, it remained <1%.
CONCLUSION: A simple scoring model comprising age, first documented cardiac rhythm, and transport time effectively stratified the likelihood of achieving favourable neurological outcome in patients satisfying the BLS TOR rule.
| Errataetall: |
CommentIn: Resuscitation. 2023 Sep;190:109909. - PMID 37499975 |
|---|---|
| Medienart: |
E-Artikel |
| Erscheinungsjahr: |
2023 |
|---|---|
| Erschienen: |
2023 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:190 |
|---|---|
| Enthalten in: |
Resuscitation - 190(2023) vom: 01. Sept., Seite 109860 |
| Sprache: |
Englisch |
|---|
| Beteiligte Personen: |
Shibahashi, Keita [VerfasserIn] |
|---|
| Links: |
|---|
| Themen: |
Journal Article |
|---|
| Anmerkungen: |
Date Completed 29.08.2023 Date Revised 01.09.2023 published: Print-Electronic CommentIn: Resuscitation. 2023 Sep;190:109909. - PMID 37499975 Citation Status MEDLINE |
|---|
| doi: |
10.1016/j.resuscitation.2023.109860 |
|---|
| funding: |
|
|---|---|
| Förderinstitution / Projekttitel: |
|
| PPN (Katalog-ID): |
NLM357721217 |
|---|
| LEADER | 01000naa a22002652 4500 | ||
|---|---|---|---|
| 001 | NLM357721217 | ||
| 003 | DE-627 | ||
| 005 | 20231226073214.0 | ||
| 007 | cr uuu---uuuuu | ||
| 008 | 231226s2023 xx |||||o 00| ||eng c | ||
| 024 | 7 | |a 10.1016/j.resuscitation.2023.109860 |2 doi | |
| 028 | 5 | 2 | |a pubmed24n1192.xml |
| 035 | |a (DE-627)NLM357721217 | ||
| 035 | |a (NLM)37270090 | ||
| 035 | |a (PII)S0300-9572(23)00173-9 | ||
| 040 | |a DE-627 |b ger |c DE-627 |e rakwb | ||
| 041 | |a eng | ||
| 100 | 1 | |a Shibahashi, Keita |e verfasserin |4 aut | |
| 245 | 1 | 0 | |a Identifying individuals satisfying the termination of resuscitation rule but having potential to achieve favourable neurological outcome following out-of-hospital cardiac arrest |
| 264 | 1 | |c 2023 | |
| 336 | |a Text |b txt |2 rdacontent | ||
| 337 | |a ƒaComputermedien |b c |2 rdamedia | ||
| 338 | |a ƒa Online-Ressource |b cr |2 rdacarrier | ||
| 500 | |a Date Completed 29.08.2023 | ||
| 500 | |a Date Revised 01.09.2023 | ||
| 500 | |a published: Print-Electronic | ||
| 500 | |a CommentIn: Resuscitation. 2023 Sep;190:109909. - PMID 37499975 | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a Copyright © 2023 Elsevier B.V. All rights reserved. | ||
| 520 | |a AIM: To develop a simple scoring model that identifies individuals satisfying the termination of resuscitation (TOR) rule but having potential to achieve favourable neurological outcome following out-of-hospital cardiac arrest (OHCA) | ||
| 520 | |a METHODS: This study analysed the All-Japan Utstein Registry from 1 January 2010 to 31 December 2019. We identified patients satisfying basic life support (BLS) and advanced life support (ALS) TOR rules and determined factors associated with favourable neurological outcome (cerebral performance category scale of 1 or 2) for each cohort using multivariable logistic regression analysis. Scoring models were derived and validated to identify patient subgroups that might benefit from continued resuscitation efforts | ||
| 520 | |a RESULTS: Among 1,695,005 eligible patients, 1,086,092 (64.1%) and 409,498 (24.2%) satisfied BLS and ALS TOR rules, respectively. One month post-arrest, 2038 (0.2%) and 590 (0.1%) patients in the BLS and ALS cohorts, respectively, achieved favourable neurological outcome. A scoring model derived for the BLS cohort (2 points for age <17 years or ventricular fibrillation/ventricular tachycardia rhythm; 1 point for age <80 years, pulseless electrical activity rhythm, or transport time <25 min) effectively stratified the probability of achieving 1-month favourable neurological outcome, with patients scoring <4 having a probability of <1%, whereas those scoring 4, 5, and 6 having probabilities of 1.1%, 7.1%, and 11.1%, respectively. In the ALS cohort, the probability increased with scores; however, it remained <1% | ||
| 520 | |a CONCLUSION: A simple scoring model comprising age, first documented cardiac rhythm, and transport time effectively stratified the likelihood of achieving favourable neurological outcome in patients satisfying the BLS TOR rule | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a Life support | |
| 650 | 4 | |a Neurological outcome | |
| 650 | 4 | |a Out-of-hospital cardiac arrest | |
| 650 | 4 | |a Scoring model | |
| 650 | 4 | |a Termination of resuscitation | |
| 700 | 1 | |a Kato, Taichi |e verfasserin |4 aut | |
| 700 | 1 | |a Hikone, Mayu |e verfasserin |4 aut | |
| 700 | 1 | |a Sugiyama, Kazuhiro |e verfasserin |4 aut | |
| 773 | 0 | 8 | |i Enthalten in |t Resuscitation |d 1972 |g 190(2023) vom: 01. Sept., Seite 109860 |w (DE-627)NLM000010049 |x 1873-1570 |7 nnns |
| 773 | 1 | 8 | |g volume:190 |g year:2023 |g day:01 |g month:09 |g pages:109860 |
| 856 | 4 | 0 | |u http://dx.doi.org/10.1016/j.resuscitation.2023.109860 |3 Volltext |
| 912 | |a GBV_USEFLAG_A | ||
| 912 | |a GBV_NLM | ||
| 951 | |a AR | ||
| 952 | |d 190 |j 2023 |b 01 |c 09 |h 109860 | ||