Pediatric anesthesia & critical care
Derivation of a clinical decision rule for termination of resuscitation in non-traumatic pediatric out-of-hospital cardiac arrest
Authors' conclusion
We derived a clinical prediction rule with high specificity and positive predictive value in prehospital settings utilizing Advanced Life Support (ALS) providers which may inform termination of resuscitation considerations in pediatric patients.
Study context
- Population
- Children with non-traumatic out-of-hospital cardiac arrest (OHCA) in the CARES database, 2013–2022
- Participants
- 21,240 children
- Outcome
- Death
Methodological detailsclinical prediction rule derivation, Least Absolute Shrinkage and Selection Operator (LASSO) logistic regression, training and test datasets
- Clinical prediction rule derivation
- LASSO logistic regression
- Training and test datasets
Main finding
As reported in the abstract
Death (PToR rule, test dataset)
Specificity
99.1%
PPV
99.8%
Observational data: associations, not effects.
Further findings
Death or survival to discharge with poor neurologic status (Pediatric Termination of Resuscitation (PToR) rule, test dataset)
- Specificity
- 99.7%
- PPV
- 99.9%
Survival to hospital discharge
- Survived to discharge
- 2,326 (11.0%)
- Survived to discharge with favorable neurologic status
- 1,894 (8.9%)
Original publication
Derivation of a clinical decision rule for termination of resuscitation in non-traumatic pediatric out-of-hospital cardiac arrest. Resuscitation. Published 18 September 2024. doi:10.
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