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Adult “termination-of-resuscitation” (TOR)-criteria may not be suitable for children - a retrospective analysis

Overview of attention for article published in Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine, December 2016
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Title
Adult “termination-of-resuscitation” (TOR)-criteria may not be suitable for children - a retrospective analysis
Published in
Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine, December 2016
DOI 10.1186/s13049-016-0328-y
Pubmed ID
Authors

Victoria Maria Rotering, Sonja Trepels-Kottek, Konrad Heimann, Jörg-Christian Brokmann, Thorsten Orlikowsky, Mark Schoberer

Abstract

Only a small number of patients survive out-of-hospital-cardiac-arrest (OHCA). The duration of CPR varies considerably and transportation of patients under CPR is often unsuccessful. Termination-of-resuscitation (TOR)-criteria aim to preclude futile resuscitation efforts. Our goal was to find out to which extent existing TOR-criteria can be transferred to paediatric OHCA-patients with special regard to their prognostic value. We performed a retrospective analysis of an eleven-year single centre patient cohort. 43 paediatric patients admitted to our institution after emergency-medical-system (EMS)-confirmed OHCA from 2003 to 2013 were included. Morrison's BLS- and ALS-TOR-rules as well as the Trauma-TOR-criteria by the American Association of EMS Physicians were evaluated for application in children, by calculating sensitivity, specificity, negative and positive predictive value for death-, as well as survival-prediction in our cohort. 26 patients achieved ROSC and 14 were discharged alive (n = 7 PCPC 1/2, n = 7 PCPC 5). Sensitivity for BLS-TOR-criteria predicting death was 48.3%, specificity 92.9%, the PPV 93.3% and the NPV 46.4%. ALS-TOR-criteria for death had a sensitivity of 10.3%, specificity of 100%, a PPV of 100% and an NPV of 35%. Retrospective application of the BLS-TOR-rule in our patient cohort identified the resuscitation of one later survivor as futile. ALS-TOR-criteria did not give false predictions of death. The proportion of CPRs that could have been abandoned is 48.2% for the BLS-TOR and only 10.3% for the ALS-TOR-rule. Both rules therefore appear not to be transferable to a paediatric population.

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Mendeley readers

Mendeley readers

The data shown below were compiled from readership statistics for 41 Mendeley readers of this research output. Click here to see the associated Mendeley record.

Geographical breakdown

Country Count As %
United Kingdom 1 2%
Unknown 40 98%

Demographic breakdown

Readers by professional status Count As %
Student > Master 6 15%
Student > Doctoral Student 5 12%
Other 4 10%
Researcher 4 10%
Student > Bachelor 2 5%
Other 9 22%
Unknown 11 27%
Readers by discipline Count As %
Medicine and Dentistry 22 54%
Nursing and Health Professions 4 10%
Social Sciences 2 5%
Arts and Humanities 1 2%
Psychology 1 2%
Other 0 0%
Unknown 11 27%
Attention Score in Context

Attention Score in Context

This research output has an Altmetric Attention Score of 2. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 10 January 2017.
All research outputs
#14,289,166
of 22,912,409 outputs
Outputs from Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
#914
of 1,260 outputs
Outputs of similar age
#227,741
of 419,655 outputs
Outputs of similar age from Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
#14
of 26 outputs
Altmetric has tracked 22,912,409 research outputs across all sources so far. This one is in the 35th percentile – i.e., 35% of other outputs scored the same or lower than it.
So far Altmetric has tracked 1,260 research outputs from this source. They typically receive a lot more attention than average, with a mean Attention Score of 10.2. This one is in the 23rd percentile – i.e., 23% of its peers scored the same or lower than it.
Older research outputs will score higher simply because they've had more time to accumulate mentions. To account for age we can compare this Altmetric Attention Score to the 419,655 tracked outputs that were published within six weeks on either side of this one in any source. This one is in the 43rd percentile – i.e., 43% of its contemporaries scored the same or lower than it.
We're also able to compare this research output to 26 others from the same source and published within six weeks on either side of this one. This one is in the 42nd percentile – i.e., 42% of its contemporaries scored the same or lower than it.