Cardiac arrest effectiveness trials have traditionally reported outcomes that focus on survival. A lack of consistency in outcome reporting between trials limits the opportunities to pool results for meta-analysis. The COSCA initiative (Core Outcome Set for Cardiac Arrest), a partnership between patients, their partners, clinicians, research scientists, and the International Liaison Committee on Resuscitation, sought to develop a consensus core outcome set for cardiac arrest for effectiveness trials. Core outcome sets are primarily intended for large, randomised clinical effectiveness trials (sometimes referred to as pragmatic trials or phase III/IV trials) rather than for pilot or efficacy studies. A systematic review of the literature combined with qualitative interviews among cardiac arrest survivors was used to generate a list of potential outcome domains. This list was prioritised through a Delphi process, which involved clinicians, patients, and their relatives/partners. An international advisory panel narrowed these down to 3 core domains by debate that led to consensus. The writing group refined recommendations for when these outcomes should be measured and further characterised relevant measurement tools. Consensus emerged that a core outcome set for reporting on effectiveness studies of cardiac arrest (COSCA) in adults should include survival, neurological function, and health-related quality of life. This should be reported as survival status and modified Rankin scale score at hospital discharge, at 30 days, or both. Health-related quality of life should be measured with ≥1 tools from Health Utilities Index version 3, Short-Form 36-Item Health Survey, and EuroQol 5D-5L at 90 days and at periodic intervals up to 1 year after cardiac arrest, if resources allow. © 2018 European Resuscitation Council and American Heart Association, Inc. Published by Elsevier B.V. All rights reserved.
Download full-text PDF |
Source |
|---|---|
| http://dx.doi.org/10.1016/j.resuscitation.2018.03.022 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
Comparing clinical only and combined clinical laboratory models for ECPR outcomes in refractory cardiac arrest.
Sci Rep
January 2025
Department Emergency and Critical Care Medicine, Changhua Christian Hospital, Changhua, 50006, Taiwan.
Extracorporeal cardiopulmonary resuscitation (ECPR) improves survival for prolonged cardiac arrest (CA) but carries significant risks and costs due to ECMO. Previous predictive models have been complex, incorporating both clinical data and parameters obtained after CPR or ECMO initiation. This study aims to compare a simpler clinical-only model with a model that includes both clinical and pre-ECMO laboratory parameters, to refine patient selection and improve ECPR outcomes.
View Article and Find Full Text PDFA Beating Heart is a Happy Heart, Especially in Patients with LV Dysfunction Undergoing Coronary Artery Bypass Grafting.
Semin Thorac Cardiovasc Surg
January 2025
Department of Cardiothoracic Surgery, Metropolitan Heart and Vascular Institute, Coon Rapids, Minnesota.
Beating-heart CABG in patients with LV dysfunction can provide the best of all words by limiting myocardial injury purported by cardioplegic arrest. Complete revascularization is possible and graft numbers are not different when compared to arrested heart CABG. Furthermore, beating-heart CABG more often reduces the need for intraoperative and postoperative mechanical support reducing the complications and costs associated with these devices.
View Article and Find Full Text PDFDevelopment of a health equity tool in resuscitation sciences and application to current research in extracorporeal cardiopulmonary resuscitation for cardiac arrest.
Resuscitation
January 2025
Department of Emergency Services, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada; Division of Emergency Medicine, Department of Medicine, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada.
Background: Extracorporeal cardiopulmonary resuscitation (ECPR) is increasingly used for adults with cardiac arrest (CA) refractory to Advanced Cardiovascular Life Support (ACLS). Concerns exist that adding ECPR could worsen health inequities, defined as differences in health outcomes that are unfair or unjust. Current guidelines do not explicitly address this issue.
View Article and Find Full Text PDFED observation unit-based delayed comfort care pathway for ED patients on life support.
Am J Emerg Med
January 2025
Departments of Emergency Medicine and Critical Care Medicine, Stanford Health Care, 900 Welch Road, Palo Alto, CA 94304, USA.
Background: Critically ill ED patients on life support may undergo transition to comfort care as decided by the surrogate decision maker. When several hours are needed for loved ones to arrive and say farewell before initiating comfort care ("delayed comfort care"), these patients require prolonged ED stays or costly intensive care unit (ICU) admissions.
Methods: A novel ED observation unit (EDOU)-based delayed comfort care pathway for ED patients on invasive mechanical ventilation and/or vasopressors was created in 2013 at Stanford Hospital.
Should digoxin immune fab be administered based solely on reported ingested amount in acute digoxin poisoning?
Am J Emerg Med
January 2025
Minnesota Regional Poison Center, Department of Pharmacy, Hennepin Healthcare, Minneapolis, MN, USA; Department of Family Medicine and Biobehavioral Health, University of Minnesota Medical School, Duluth Campus, Duluth, MN, USA. Electronic address:
Acute digoxin poisoning is increasingly uncommon in emergency medicine. Furthermore, controversy exists regarding indications for antidotal digoxin immune fab in acute poisoning. In healthy adults, the fab prescribing information recommends administration based on "known consumption of fatal doses of digoxin: ≥10mg," while many emergency medicine textbooks suggest fab administration be driven by clinical features or potassium concentration.
View Article and Find Full Text PDFWant AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!