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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.

Twitter Demographics

The data shown below were collected from the profiles of 3 tweeters who shared this research output. Click here to find out more about how the information was compiled.

Mendeley readers

The data shown below were compiled from readership statistics for 27 Mendeley readers of this research output. Click here to see the associated Mendeley record.

Geographical breakdown

Country Count As %
United Kingdom 1 4%
Unknown 26 96%

Demographic breakdown

Readers by professional status Count As %
Student > Master 6 22%
Other 4 15%
Student > Doctoral Student 3 11%
Researcher 3 11%
Student > Postgraduate 2 7%
Other 5 19%
Unknown 4 15%
Readers by discipline Count As %
Medicine and Dentistry 18 67%
Nursing and Health Professions 2 7%
Social Sciences 2 7%
Arts and Humanities 1 4%
Unknown 4 15%

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
#4,280,211
of 8,882,101 outputs
Outputs from Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
#396
of 651 outputs
Outputs of similar age
#142,999
of 305,314 outputs
Outputs of similar age from Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
#13
of 28 outputs
Altmetric has tracked 8,882,101 research outputs across all sources so far. This one is in the 49th percentile – i.e., 49% of other outputs scored the same or lower than it.
So far Altmetric has tracked 651 research outputs from this source. They typically receive a little more attention than average, with a mean Attention Score of 6.2. This one is in the 33rd percentile – i.e., 33% 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 305,314 tracked outputs that were published within six weeks on either side of this one in any source. This one has gotten more attention than average, scoring higher than 50% of its contemporaries.
We're also able to compare this research output to 28 others from the same source and published within six weeks on either side of this one. This one is in the 39th percentile – i.e., 39% of its contemporaries scored the same or lower than it.