Resuscitation
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Withdrawal of life-sustaining therapies for perceived poor neurological prognosis is the most common cause of death for patients hospitalized after resuscitation from cardiac arrest. Accurate neuroprognostication is challenging and high stakes, so guidelines recommend multimodality testing. We quantified the frequency and timing with which guideline recommended diagnostics were acquired prior to in-hospital death after cardiac arrest. ⋯ In this retrospective cohort, we found few patients hospitalized after out-of-hospital cardiac arrest underwent guideline-recommended prognostic testing. If validated in prospective cohorts with more granular clinical information, better guideline adherence and more frequent use of multimodality neuroprognostication offer an opportunity to improve quality of post-arrest care.
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Observational Study
Diagnostic Yield, Safety, and Outcomes of Head-to-Pelvis Sudden Death CT Imaging in Post Arrest Care: The CT FIRST Cohort Study.
Our aim was to test whether a head-to-pelvis CT scan improves diagnostic yield and speed to identify causes for out of hospital circulatory arrest (OHCA). ⋯ NCT03111043.
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Early, accurate outcome prediction after out-of-hospital cardiac arrest (OHCA) is critical for clinical decision-making and resource allocation. We sought to validate the revised post-Cardiac Arrest Syndrome for Therapeutic hypothermia (rCAST) score in a United States cohort and compare its prognostic performance to the Pittsburgh Cardiac Arrest Category (PCAC) and Full Outline of UnResponsiveness (FOUR) scores. ⋯ The rCAST score can reliably predict poor outcome in a United States cohort of OHCA patients regardless of TTM status and outperforms the PCAC score.