TY  - JOUR
PY  - 2016//
TI  - Can we identify termination of resuscitation criteria in cardiac arrest due to drowning: results from the French national out-of-hospital cardiac arrest registry
JO  - Journal of evaluation in clinical practice
A1  - Hubert, Hervé
A1  - Escutnaire, Joséphine
A1  - Michelet, Pierre
A1  - Babykina, Evgéniya
A1  - El Khoury, Carlos
A1  - Tazarourte, Karim
A1  - Vilhelm, Christian
A1  - El Hiki, Lahcen
A1  - Guinhouya, Benjamin
A1  - Gueugniaud, Pierre-Yves
SP  - 924
EP  - 931
VL  - 22
IS  - 6
N2  - RATIONALE, AIMS AND OBJECTIVES: The aim of this study was to describe the cohort of persons having experiences fatal and non-fatal drowning events, registered in the French cardiac arrest registry and to identify termination of resuscitation criteria. <br><br>METHODS: We performed a prospective multicenter study based on data from French cardiac arrest registry database. All patients with cardiac arrest after drowning (CAD) recorded between July 2011 and November 2014 were included. The population description was carried out by medians [interquartile ranges (IQR)] or frequencies. The characteristics were compared in terms of the primary endpoint (alive vs dead at hospital admission) using chi-square or Fisher's exact and the Mann-Whitney U test. The predictive model was carried out using the multivariate logistic regression. <br><br>RESULTS: The analysis included 234 CAD. The majority of patients were adults (83.6%) and males (64.5%). Most of the submersions occurred out of home (75.6%). We recorded 66.7% of incidents in fresh water. About a third of CAD was witnessed of which 33.8% had an immediate basic life support. Most of CAD patients received an advanced cardiac life support (87.2%). The median Mobile Medical Team response time was 22 [15-30] minutes. At hospital, 40.6% of patients were alive. Twenty one patients (9.0%) were discharged alive. Among them, 17 had a good neurological outcome. Faster interventions generally resulted in higher survival chances (Mobile Medical Team response time OR: 0.960[0.925; 0.996]; P = 0.0.031; no flow duration OR: 0.535[0.313; 0.913]; P = 0.022) if associated with ventilation (OR: 6.742[2.043; 22.250]; P = 0.002). Age (OR: 0.971[0.955; 0.988]; P = 0.001) and location outside (OR: 0.203[0.064; 0.625]; P = 0.007) are the other criteria of our model. <br><br>CONCLUSIONS: The model is helpful to highlight explanative variables concerning CAD patients' outcome. The next step is the validation of these five factors by a larger study. Prevention and public training to lifesaving behaviours must be considered as priorities in French public health programmes.<br><br>© 2016 John Wiley & Sons, Ltd.<p />  <p>Language: en</p>
LA  - en
SN  - 1356-1294
UR  - http://dx.doi.org/10.1111/jep.12562
ID  - ref1
ER  -