For Out-of-Hospital Cardiac Arrest, Knowing When to Quit

TORONTO, Aug. 2 -- Most out-of-hospital cardiac arrests end on the scene, and investigators here have devised a simple clinical prediction rule to help emergency workers know when to stop.
Implementation of a clinical prediction rule based on three simple factors would reduce futile resuscitation efforts by almost 63%, reported the Termination of Resuscitation (TOR) trial investigators in the Aug. 3 issue of the New England Journal of Medicine.
"The prediction rule had a positive predictive value of 99.5% [for death] and a specificity of 90.2% [for death]," wrote Laurie J. Morrison, M.D., of the University of Toronto, and colleagues there and at Owen Sound (Ontario) Hospital.
The investigators analyzed data from 1,240 adult patients treated by 24 emergency medical systems in the province of Ontario from Jan. 1, 2002 to Jan. 30, 2004.