Abstract
Background
Prehospital termination of resuscitation (TOR) rules can be recommended for adults
with out-of-hospital cardiac arrests (OHCAs). This study aimed to investigate whether
adult basic life support (BLS) and advanced life support (ALS) TOR rules can predict
neurologically unfavorable one-month outcome for pediatric OHCA patients.
Methods
From a nationwide population-based observational cohort study, we extracted data of
consecutive pediatric OHCA patients (0–17 years old) from January 1, 2005, to December
31, 2011. The BLS TOR rule has three criteria, whereas the ALS TOR rule includes two
additional criteria. We selected pediatric OHCA patients that met all criteria for
each TOR rule and calculated the specificity and positive predictive value (PPV) of
each TOR rule for identifying pediatric OHCA patients who did not have neurologically
favorable one-month outcome.
Results
Of the 12,740 pediatric OHCA patients eligible for the evaluation of the BLS TOR rule,
10,803 patients met the BLS TOR rule, with a specificity of 0.785 and a PPV of 0.987
for predicting a lack of neurologically favorable one-month survival. Of the 2,091
for the ALS TOR rule, 381 patients met the ALS TOR rule, with a specificity of 0.986
and a PPV of 0.997 for predicting neurologically unfavorable one-month outcome.
Conclusions
The adult BLS and ALS TOR rules had a high PPV for predicting pediatric OHCA patients
without a neurologically favorable survival at one month after onset.
Keywords
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Article info
Publication history
Published online: December 28, 2022
Accepted:
December 22,
2022
Received in revised form:
December 13,
2022
Received:
October 25,
2022
Publication stage
In Press Journal Pre-ProofIdentification
Copyright
© 2022 Elsevier B.V. All rights reserved.
