8 research outputs found
A Study on the Use and Awareness of Hearer-oriented Honorific System in Presentation Discourse - Focused on Shifting between Hapsyo- and Haeyo-style of Intermediate Level KAP Learners -
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A Study of Social Workers’ Reflections on the Supportive Practice for Community Welfare Center Single Parent Self-Help Groups based on Participatory Action Research
No full textA Qualitative Case Study on the Low - Income Divorced Single Parents Self - help Group: Focusing on the Case of ‘Jinggomdari’ at Wolgye Social Welfare Center
No full textA Participatory Action Research of Social Workers on the Practice Methods for Single Parents Self-help Groups in Community Welfare Centers
No full textConfirmation of COVID-19 in Out-of-Hospital Cardiac Arrest Patients and Postmortem Management in the Emergency Department during the COVID-19 Outbreak
No full textExternal validation of multimodal termination of resuscitation rules for out-of-hospital cardiac arrest patients in the COVID-19 era
No full textAbstract
Background
Futile resuscitation for out-of-hospital cardiac arrest (OHCA) patients in the coronavirus disease (COVID)-19 era can lead to risk of disease transmission and unnecessary transport. Various existing basic or advanced life support (BLS or ALS, respectively) rules for the termination of resuscitation (TOR) have been derived and validated in North America and Asian countries. This study aimed to evaluate the external validation of these rules in predicting the survival outcomes of OHCA patients in the COVID-19 era.
Methods
This was a multicenter observational study using the WinCOVID-19 Daegu registry data collected during February 18–March 31, 2020. The subjects were patients who showed cardiac arrest of presumed cardiac etiology. The outcomes of each rule were compared to the actual patient survival outcomes. The sensitivity, specificity, false positive value (FPV), and positive predictive value (PPV) of each TOR rule were evaluated.
Results
In total, 170 of the 184 OHCA patients were eligible and evaluated. TOR was recommended for 122 patients based on the international basic life support termination of resuscitation (BLS-TOR) rule, which showed 85% specificity, 74% sensitivity, 0.8% FPV, and 99% PPV for predicting unfavorable survival outcomes. When the traditional BLS-TOR rules and KoCARC TOR rule II were applied to our registry, one patient met the TOR criteria but survived at hospital discharge. With regard to the FPV (upper limit of 95% confidence interval < 5%), specificity (100%), and PPV (> 99%) criteria, only the KoCARC TOR rule I, which included a combination of three factors including not being witnessed by emergency medical technicians, presenting with an asystole at the scene, and not experiencing prehospital shock delivery or return of spontaneous circulation, was found to be superior to all other TOR rules.
Conclusion
Among the previous nine BLS and ALS TOR rules, KoCARC TOR rule I was most suitable for predicting poor survival outcomes and showed improved diagnostic performance. Further research on variations in resources and treatment protocols among facilities, regions, and cultures will be useful in determining the feasibility of TOR rules for COVID-19 patients worldwide.
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