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Pre-arrest prediction of survival following in-hospital cardiac arrest : a systematic review of diagnostic test accuracy studies
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Lauridsen, Kasper G., Djärv, Therese, Breckwoldt, Jan, Tjissen, Janice A., Couper, Keith and Greif, Robert (2022) Pre-arrest prediction of survival following in-hospital cardiac arrest : a systematic review of diagnostic test accuracy studies. Resuscitation, 179 . pp. 141-151. doi:10.1016/j.resuscitation.2022.07.041 ISSN 0300-9572.
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Official URL: http://dx.doi.org/10.1016/j.resuscitation.2022.07....
Abstract
Aim:
To evaluate the test accuracy of pre-arrest clinical decision tools for in-hospital cardiac arrest survival outcomes.
Methods:
We searched Medline, Embase, and Cochrane Library from inception through January 2022 for randomized and non-randomized studies. We used the Quality Assessment of Diagnostic Accuracy Studies framework to evaluate risk of bias, and Grading of Recommendations Assessment, Development and Evaluation methodology to evaluate certainty of evidence. We report sensitivity, specificity, positive predictive outcome, and negative predictive outcome for prediction of survival outcomes. PROSPERO CRD42021268005.
Results:
We searched 2517 studies and included 23 studies using 13 different scores: 12 studies investigating 8 different scores assessing survival outcomes and 11 studies using 5 different scores to predict neurological outcomes. All were historical cohorts/ case control designs including adults only. Test accuracy for each score varied greatly. Across the 12 studies investigating 8 different scores assessing survival to hospital discharge/ 30-day survival, the negative predictive values (NPVs) for the prediction of survival varied from 55.6% to 100%. The GO-FAR score was evaluated in 7 studies with NPVs for survival with cerebral performance category (CPC) 1 ranging from 95.0% to 99.2%. Two scores assessed survival with CPC ≤2 and these were not externally validated. Across all prediction scores, certainty of evidence was rated as very low.
Conclusions:
We identified very low certainty evidence across 23 studies for 13 different pre-arrest prediction scores to outcome following IHCA. No score was sufficiently reliable to support its use in clinical practice. We identified no evidence for children.
Item Type: | Journal Article | ||||||||
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Subjects: | R Medicine > RC Internal medicine | ||||||||
Divisions: | Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School > Clinical Trials Unit Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School |
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Library of Congress Subject Headings (LCSH): | Cardiac arrest -- Treatment, Cardiac resuscitation -- Evaluation, Hospital care, CPR (First aid), Do-not-resuscitate orders, Clinical medicine -- Decision making | ||||||||
Journal or Publication Title: | Resuscitation | ||||||||
Publisher: | Elsevier B.V. | ||||||||
ISSN: | 0300-9572 | ||||||||
Official Date: | 1 October 2022 | ||||||||
Dates: |
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Volume: | 179 | ||||||||
Page Range: | pp. 141-151 | ||||||||
DOI: | 10.1016/j.resuscitation.2022.07.041 | ||||||||
Status: | Peer Reviewed | ||||||||
Publication Status: | Published | ||||||||
Access rights to Published version: | Open Access (Creative Commons) | ||||||||
Description: | The Education, Implementation, Team Task Force of the International Liaison Committee on Resuscitation ILCOR |
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Date of first compliant deposit: | 8 August 2022 | ||||||||
Date of first compliant Open Access: | 15 August 2022 | ||||||||
RIOXX Funder/Project Grant: |
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