Resuscitation
-
Multicenter Study Observational Study
Deep-learning-based out-of-hospital cardiac arrest prognostic system to predict clinical outcomes.
Out-of-hospital cardiac arrest (OHCA) is a major healthcare burden, and prognosis is critical in decision-making for treatment and the withdrawal of life-sustaining therapy. This study aimed to develop and validate a deep-learning-based out-of-hospital cardiac arrest prognostic system (DCAPS) for predicting neurologic recovery and survival to discharge. ⋯ The DCAPS predicted neurologic recovery and survival to discharge of OHCA patients accurately and outperformed the conventional method and other machine-learning methods.
-
Multicenter Study
Early withdrawal of life support after resuscitation from cardiac arrest is common and may result in additional deaths.
"Early" withdrawal of life support therapies (eWLST) within the first 3 calendar days after resuscitation from cardiac arrest (CA) is discouraged. We evaluated a prospective multicenter registry of patients admitted to hospitals after resuscitation from CA to determine predictors of eWLST and estimate its impact on outcomes. ⋯ Early withdrawal of life support occurs frequently after cardiac arrest. Although the mortality of patients matched to those with eWLST was high, these data showed excess mortality with eWLST.
-
Multicenter Study Observational Study
The Effect of Fractional Inspired Oxygen Concentration on Early Warning Score Performance: a database analysis.
To calculate fractional inspired oxygen concentration (FiO2) thresholds in ward patients and add these to the National Early Warning Score (NEWS). To evaluate the performance of NEWS-FiO2 against NEWS when predicting in-hospital death and unplanned intensive care unit (ICU) admission. ⋯ NEWS-FiO2 generates a performance gain over NEWS when studied in ward patients requiring oxygen. This warrants further study, particularly in patients with respiratory disorders.
-
Multicenter Study
Cost effectiveness and quality of life analysis of extracorporeal cardiopulmonary resuscitation (ECPR) for refractory cardiac arrest.
The use of extracorporeal membrane oxygenation (ECMO) in refractory cardiac arrest (ECPR) has increased exponentially. ECPR is a resource intensive service and its cost effectiveness has yet to be demonstrated. We sought to complete a cost analysis with modelling of cost effectiveness and quality of life outcomes. We sought to complete a cost analysis with modelling of cost effectiveness and quality of life outcomes of patients who have undergone ECPR. ⋯ ECMO support for refractory cardiac arrests is cost effective and compares favourably to accepted cost effectiveness thresholds.
-
Multicenter Study
Time of on-scene resuscitation in out of-hospital cardiac arrest patients transported without return of spontaneous circulation.
In out-of-hospital cardiac arrest (OHCA), return of spontaneous circulation (ROSC) on scene occurs only in a minority of patients. The optimal duration of resuscitation on scene before transport with ongoing cardiopulmonary resuscitation (CPR) is unknown. ⋯ In OHCA patients transported with ongoing CPR the survival rate significantly declines when time on scene increases.