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Sökning: WFRF:(Wanscher M.) > (2015-2019) > Early withdrawal of...

Early withdrawal of life support after resuscitation from cardiac arrest is common and may result in additional deaths

May, Teresa L. (författare)
Tufts Medical Center
Ruthazer, Robin (författare)
Tufts Medical Center
Riker, Richard R. (författare)
Maine Medical Center
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Friberg, Hans (författare)
Lund University,Lunds universitet,Centrum för hjärtstopp,Forskargrupper vid Lunds universitet,Center for cardiac arrest,Lund University Research Groups,Skåne University Hospital
Patel, Nainesh (författare)
Lehigh Valley Hospital
Soreide, Eldar (författare)
Stavanger University Hospital,University of Bergen
Hand, Robert (författare)
Eastern Maine Medical Center
Stammet, Pascal (författare)
National Fire and Rescue Corps
Dupont, Allison (författare)
Heart Center of Northeast Georgia Medical Center
Hirsch, Karen G. (författare)
Stanford University
Agarwal, Sachin (författare)
New York Presbyterian Hospital/Columbia University Medical Center
Wanscher, Michael J. (författare)
Copenhagen University Hospital
Dankiewicz, Josef (författare)
Lund University,Lunds universitet,Kardiologi,Sektion II,Institutionen för kliniska vetenskaper, Lund,Medicinska fakulteten,Cardiology,Section II,Department of Clinical Sciences, Lund,Faculty of Medicine,Skåne University Hospital
Nielsen, Niklas (författare)
Lund University,Lunds universitet,Kliniska Vetenskaper, Helsingborg,Sektion II,Institutionen för kliniska vetenskaper, Lund,Medicinska fakulteten,Centrum för hjärtstopp,Forskargrupper vid Lunds universitet,Clinical Sciences, Helsingborg,Section II,Department of Clinical Sciences, Lund,Faculty of Medicine,Center for cardiac arrest,Lund University Research Groups,Helsingborg Hospital
Seder, David B. (författare)
Maine Medical Center
Kent, David M. (författare)
Tufts Medical Center
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 (creator_code:org_t)
Elsevier BV, 2019
2019
Engelska.
Ingår i: Resuscitation. - : Elsevier BV. - 0300-9572. ; 139, s. 308-313
Relaterad länk:
http://dx.doi.org/10...
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https://europepmc.or...
https://lup.lub.lu.s...
https://doi.org/10.1...
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  • Tidskriftsartikel (refereegranskat)
Abstract Ämnesord
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  • Aim: “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. Methods: CA survivors enrolled from 2012–2017 in the International Cardiac Arrest Registry (INTCAR) were included. We developed a propensity score for eWLST and matched a cohort with similar probabilities of eWLST who received ongoing care. The incidence of good outcome (Cerebral Performance Category of 1 or 2) was measured across deciles of eWLST in the matched cohort. Results: 2688 patients from 24 hospitals were included. Median ischemic time was 20 (IQR 11, 30) minutes, and 1148 (43%) had an initial shockable rhythm. Withdrawal of life support occurred in 1162 (43%) cases, with 459 (17%) classified as eWLST. Older age, initial non-shockable rhythm, increased ischemic time, shock on admission, out-of-hospital arrest, and admission in the United States were each independently associated with eWLST. All patients with eWLST died, while the matched cohort, good outcome occurred in 21% of patients. 19% of patients within the eWLST group were predicted to have a good outcome, had eWLST not occurred. Conclusions: 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.

Ämnesord

MEDICIN OCH HÄLSOVETENSKAP  -- Klinisk medicin -- Anestesi och intensivvård (hsv//swe)
MEDICAL AND HEALTH SCIENCES  -- Clinical Medicine -- Anesthesiology and Intensive Care (hsv//eng)

Nyckelord

Arrest
End-of-life
Palliative
Prognostication
Support
Withdrawal
WLST

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art (ämneskategori)
ref (ämneskategori)

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