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The predictive performance of current termination-of-resuscitation rules in patients following out-of-hospital cardiac arrest in Asian countries: A cross-sectional multicentre study
BACKGROUND: Termination-of-resuscitation rules (TORRs) in out-of-hospital cardiac arrest (OHCA) patients have been applied in western countries; in Asia, two TORRs were developed and have not been externally validated widely. We aimed to externally validate the TORRs using the registry of Pan-Asian...
Autores principales: | , , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
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Public Library of Science
2022
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9365191/ https://www.ncbi.nlm.nih.gov/pubmed/35947598 http://dx.doi.org/10.1371/journal.pone.0270986 |
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author | Hsu, Shu-Hsien Sun, Jen-Tang Huang, Edward Pei-Chuan Nishiuchi, Tatsuya Song, Kyoung Jun Leong, Benjamin Rahman, Nik Hisamuddin Nik AB Khruekarnchana, Pairoj Naroo, GY Hsieh, Ming-Ju Chang, Shu-Hui Chiang, Wen-Chu Huei-Ming Ma, Matthew |
author_facet | Hsu, Shu-Hsien Sun, Jen-Tang Huang, Edward Pei-Chuan Nishiuchi, Tatsuya Song, Kyoung Jun Leong, Benjamin Rahman, Nik Hisamuddin Nik AB Khruekarnchana, Pairoj Naroo, GY Hsieh, Ming-Ju Chang, Shu-Hui Chiang, Wen-Chu Huei-Ming Ma, Matthew |
author_sort | Hsu, Shu-Hsien |
collection | PubMed |
description | BACKGROUND: Termination-of-resuscitation rules (TORRs) in out-of-hospital cardiac arrest (OHCA) patients have been applied in western countries; in Asia, two TORRs were developed and have not been externally validated widely. We aimed to externally validate the TORRs using the registry of Pan-Asian Resuscitation Outcomes Study (PAROS). METHODS: PAROS enrolled 66,780 OHCA patients in seven Asian countries from 1 January 2009 to 31 December 2012. The American Heart Association-Basic Life Support and AHA-ALS (AHA-BLS), AHA-Advanced Life Support (AHA-ALS), Goto, and Shibahashi TORRs were selected. The diagnostic test characteristics and area under the receiver operating characteristic curve (AUC) were calculated. We further determined the most suitable TORR in Asia and analysed the variable differences between subgroups. RESULTS: We included 55,064 patients in the final analysis. The sensitivity, specificity, negative predictive value, positive predictive value, and AUC, respectively, for AHA-BLS, AHA-ALS, Goto, Shibashi TORRs were 79.0%, 80.0%, 19.6%, 98.5%, and 0.80; 48.6%, 88.3%, 9.8%, 98.5%, and 0.60; 53.8%, 91.4%, 11.2%, 99.0%, and 0.73; and 35.0%, 94.2%, 8.4%, 99.0%, and 0.65. In countries using the Goto TORR with PPV<99%, OHCA patients were younger, had more males, a higher rate of shockable rhythm, witnessed collapse, pre-hospital defibrillation, and survival to discharge, compared with countries using the Goto TORR with PPV ≥99%. CONCLUSIONS: There was no single TORR fit for all Asian countries. The Goto TORR can be considered the most suitable; however, a high predictive performance with PPV ≥99% was not achieved in three countries using it (Korea, Malaysia, and Taiwan). |
format | Online Article Text |
id | pubmed-9365191 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2022 |
publisher | Public Library of Science |
record_format | MEDLINE/PubMed |
spelling | pubmed-93651912022-08-11 The predictive performance of current termination-of-resuscitation rules in patients following out-of-hospital cardiac arrest in Asian countries: A cross-sectional multicentre study Hsu, Shu-Hsien Sun, Jen-Tang Huang, Edward Pei-Chuan Nishiuchi, Tatsuya Song, Kyoung Jun Leong, Benjamin Rahman, Nik Hisamuddin Nik AB Khruekarnchana, Pairoj Naroo, GY Hsieh, Ming-Ju Chang, Shu-Hui Chiang, Wen-Chu Huei-Ming Ma, Matthew PLoS One Research Article BACKGROUND: Termination-of-resuscitation rules (TORRs) in out-of-hospital cardiac arrest (OHCA) patients have been applied in western countries; in Asia, two TORRs were developed and have not been externally validated widely. We aimed to externally validate the TORRs using the registry of Pan-Asian Resuscitation Outcomes Study (PAROS). METHODS: PAROS enrolled 66,780 OHCA patients in seven Asian countries from 1 January 2009 to 31 December 2012. The American Heart Association-Basic Life Support and AHA-ALS (AHA-BLS), AHA-Advanced Life Support (AHA-ALS), Goto, and Shibahashi TORRs were selected. The diagnostic test characteristics and area under the receiver operating characteristic curve (AUC) were calculated. We further determined the most suitable TORR in Asia and analysed the variable differences between subgroups. RESULTS: We included 55,064 patients in the final analysis. The sensitivity, specificity, negative predictive value, positive predictive value, and AUC, respectively, for AHA-BLS, AHA-ALS, Goto, Shibashi TORRs were 79.0%, 80.0%, 19.6%, 98.5%, and 0.80; 48.6%, 88.3%, 9.8%, 98.5%, and 0.60; 53.8%, 91.4%, 11.2%, 99.0%, and 0.73; and 35.0%, 94.2%, 8.4%, 99.0%, and 0.65. In countries using the Goto TORR with PPV<99%, OHCA patients were younger, had more males, a higher rate of shockable rhythm, witnessed collapse, pre-hospital defibrillation, and survival to discharge, compared with countries using the Goto TORR with PPV ≥99%. CONCLUSIONS: There was no single TORR fit for all Asian countries. The Goto TORR can be considered the most suitable; however, a high predictive performance with PPV ≥99% was not achieved in three countries using it (Korea, Malaysia, and Taiwan). Public Library of Science 2022-08-10 /pmc/articles/PMC9365191/ /pubmed/35947598 http://dx.doi.org/10.1371/journal.pone.0270986 Text en © 2022 Hsu et al https://creativecommons.org/licenses/by/4.0/This is an open access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by/4.0/) , which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. |
spellingShingle | Research Article Hsu, Shu-Hsien Sun, Jen-Tang Huang, Edward Pei-Chuan Nishiuchi, Tatsuya Song, Kyoung Jun Leong, Benjamin Rahman, Nik Hisamuddin Nik AB Khruekarnchana, Pairoj Naroo, GY Hsieh, Ming-Ju Chang, Shu-Hui Chiang, Wen-Chu Huei-Ming Ma, Matthew The predictive performance of current termination-of-resuscitation rules in patients following out-of-hospital cardiac arrest in Asian countries: A cross-sectional multicentre study |
title | The predictive performance of current termination-of-resuscitation rules in patients following out-of-hospital cardiac arrest in Asian countries: A cross-sectional multicentre study |
title_full | The predictive performance of current termination-of-resuscitation rules in patients following out-of-hospital cardiac arrest in Asian countries: A cross-sectional multicentre study |
title_fullStr | The predictive performance of current termination-of-resuscitation rules in patients following out-of-hospital cardiac arrest in Asian countries: A cross-sectional multicentre study |
title_full_unstemmed | The predictive performance of current termination-of-resuscitation rules in patients following out-of-hospital cardiac arrest in Asian countries: A cross-sectional multicentre study |
title_short | The predictive performance of current termination-of-resuscitation rules in patients following out-of-hospital cardiac arrest in Asian countries: A cross-sectional multicentre study |
title_sort | predictive performance of current termination-of-resuscitation rules in patients following out-of-hospital cardiac arrest in asian countries: a cross-sectional multicentre study |
topic | Research Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9365191/ https://www.ncbi.nlm.nih.gov/pubmed/35947598 http://dx.doi.org/10.1371/journal.pone.0270986 |
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