Recommended guidelines for uniform reporting of data from out-of-hospital cardiac arrest: the ‘Utstein style’

Chamberlain, Douglas; Cummins, Richard O.; Abramson, Norman S.; Allen, M.; Baskett, Peter; Becker, Lance B.; Bossaert, Leo; Delooz, Herman; Dick, W.; Eisenberg, Mickey S.; Evans, T.R. Jeffry; Holmberg, Stig; Kerber, Richard E.; Mullie, A.; Ornato, Joseph P.; Sandoe, E; Skulberg, A; Tunstall-Pedoe, H; Swanson, Richard W.; Thies, William

doi:10.1016/0300-9572(91)90061-3

Cited by 327 publications

(42 citation statements)

References 73 publications

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“…First, we extracted a dataset comprising 217,969 bystander-witnessed OHCA without any prehospital involvement of physicians due to the following reasons; (1) some of these cases received prehospital advanced life support (ALS) performed by physicians on duty [16], (2) these physicians on duty played primary roles in the treatment and transportation of patients, (3) according to the Utstein Recommendations [17,18], these physicians on duty should not be categorized as a bystander. Then, we excluded the following cases lacking the essential information for analysis; 160 cases in which the relationship of the bystander to the victim was unknown and 2753 cases in which the provision of dispatcher-assisted CPR (DA-CPR) was unknown.…”

Section: Data Selectionmentioning

confidence: 99%

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Impact of bystander-performed ventilation on functional outcomes after cardiac arrest and factors associated with ventilation-only cardiopulmonary resuscitation: A large observational study

et al. 2015

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Aim: To determine the effectiveness of ventilations in bystander cardiopulmonary resuscitation (BCPR) and to identify the factors associated with ventilation-only BCPR.Methods: From out-of-hospital cardiac arrest (OHCA) data prospectively collected from 2005 to 2011 in Japan, we extracted data for 210,134 bystander-witnessed OHCAs with complete datasets but no prehospital involvement of physician [no BCPR, 115,733;2,093; 61,075; and conventional (compressions + ventilations) BCPR, 31,233] and determined the factors associated with 1-month neurologically favourable survival using simple and multivariable logistic regression analyses. In 91,885 patients with known BCPR durations, we determined the factors associated with ventilation-only BCPR.Results: The rate of survival in the no BCPR, ventilation-only, compression-only and conventional group was 2.8%, 3.9%, 4.5% and 5.0%, respectively. After adjustment for other factors associated with outcomes, the survival rate in the ventilation-only group was higher than that in the no BCPR group (adjusted OR; 95% CI, 1.29; 1.01-1.63), but lower than that in the compression-only (0.76; 0.59-0.96) or conventional groups (0.70; 0.55-0.89). Conventional CPR had the highest OR for survival in almost all OHCA subgroups. The adjusted OR (95% CI) for survival after dividing BCPR into ventilation and compression components were 1.19 (1.11-1.27) and 1.60 (1.51-1.69), respectively. Older guidelines, female sex, younger patient age, bystander-initiated CPR without instruction, early BCPR and short BCPR duration were associated with ventilation-only BCPR.Conclusions: Ventilation is a significant component of BCPR, but alone is less effective than compression in improving neurologically favourable survival after OHCAs.Word count: 247

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Section: Data Selectionmentioning

confidence: 99%

“…The primary outcome was the 1-M neurologically favourable survival (cerebral performance category, 1 or 2) in the main part of this study [16,17]. Ventilation-only BCPR was the primary outcome in another part of this study.…”

Section: Outcomementioning

confidence: 99%

Impact of bystander-performed ventilation on functional outcomes after cardiac arrest and factors associated with ventilation-only cardiopulmonary resuscitation: A large observational study

et al. 2015

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“…[12][13][14][15][16][17][18][19] . Na ocasião, havia a preocupação com uma comparação adequada entre os resultados dos esforços relacionados com ressuscitação, efetuados tanto em diferentes países, como dentro de um mesmo país, por falta de definições e metodologias uniformes.…”

Section: -Padronização Dos Carros De Emergênciaunclassified

“…Uma parada cardía-ca é definida, no estilo Utstein, como " parada da atividade mecânica cardíaca... confirmada pela ausência de pulso detectável, inconsciência e apnéia (ou respirações agôni-cas)" [11][12][13][14][15][16][17][18][19] . Sabe-se, entretanto, que um paciente pode ter tido muitos graus de disfunções cardíacas e respiratórias, não caracterizadas como paradas cardíacas, tais como hipotensão ou choque.…”

Section: Ressuscitação Intra-hospitalarunclassified

Diretriz de apoio ao suporte avançado de vida em cardiologia - Código Azul - Registro de ressuscitação normatização do carro de emergência

Guimarães¹,

Timerman²,

Souza³

et al. 2003

Arq. Bras. Cardiol.

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“…The experimental method might involve a new form of thoraco-abdominal compression, a new method of ventilation, a new drug, a new defibrillation waveform, or a new sequence of live-saving maneuvers. Since the purpose of resuscitation is the restoration of life, clinical trials ultimately focus on survival data [6][7][8]. Generally, one or more of three classical outcome measures is tabulated in such studies: return of spontaneous circulation (ROSC), 24 h survival, or survival to hospital discharge.…”

Section: Describing An Individual Studymentioning

confidence: 99%

Consensus evidence evaluation in resuscitation research: analysis of Type I and Type II errors

Babbs

2001

Resuscitation

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Objective: This paper addresses the following statistical question: 'if genuine improvements in cardiopulmonary resuscitation (CPR) were discovered that doubled the probability of resuscitation success in a series of randomized clinical trials, would they be recognized and incorporated into consensus guidelines?'Methods: Statistical powers for hypothetical individual clinical trials comparing experimental and control CPR were computed as a function of the study N when the true probabilities for immediate survival, 24 h survival, and discharge survival in the experimental group were twice those in the control group. Next, the binomial distributions describing the numbers of statistically significant studies in a series of equally powered trials of the same intervention were determined. These were compared with varying criteria for consensus among expert reviewers, expressed in terms of the number of 'positive' studies showing a statistically significant difference that reviewers would require before approving the experimental method.Results: False-negative evaluations (i.e. failures to approve a technique that actually doubled survival) were extremely common under a wide range of realistic assumptions and consensus criteria, especially when simulated long-term survival data were considered. Similar methods showed that false-positive evaluations would be extremely rare, provided that at least two of the clinical trials in a series showed a statistically significant benefit of the experimental method.Conclusions: Optimization of evidence evaluation can and should be carried out to make better use of available data in creating resuscitation guidelines. One simple approach is the 'two and one quarter test': if at least two well-conducted studies in a series are significantly positive (P<0.05) comprising at least one-quarter of all studies in the series, a positive effect can be inferred with small Type I and Type II errors. In addition, greater reliance on modern, unbiased methods such as cumulative meta-analysis is needed to increase the sensitivity of evidence evaluation for detecting useful innovations in resuscitation.

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Recommended guidelines for uniform reporting of data from out-of-hospital cardiac arrest: the ‘Utstein style’

Cited by 327 publications

References 73 publications

Impact of bystander-performed ventilation on functional outcomes after cardiac arrest and factors associated with ventilation-only cardiopulmonary resuscitation: A large observational study

Impact of bystander-performed ventilation on functional outcomes after cardiac arrest and factors associated with ventilation-only cardiopulmonary resuscitation: A large observational study

Diretriz de apoio ao suporte avançado de vida em cardiologia - Código Azul - Registro de ressuscitação normatização do carro de emergência

Consensus evidence evaluation in resuscitation research: analysis of Type I and Type II errors

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