Medical futility regarding cardiopulmonary resuscitation in in-hospital cardiac arrests of adult patients: A systematic review and Meta-analysis

Predicting neurological outcome in adult patients with cardiac arrest: systematic review and meta-analysis of prediction model performance

“…A systematic review and meta-analysis assessed definitions of medical futility regarding CPR and the predictive value of pre-arrest risk scores including the GO-FAR score [ 17 ]. In a meta-analysis, a GO-FAR score of 14 points or higher predicted poor neurological outcome including death defined as a CPC score of ≥ 2 with a pooled specificity of 95%.…”

“…Another important application of CPM is to predict outcome after cardiac arrest in a pre-arrest setting, specifically in code status discussions [ 16 , 17 ]. As in-hospital cardiac arrest (IHCA) is a frequent emergency with potentially devastating outcomes and high health care costs [ 18 , 19 ], shared decision-making with patients at hospital admission concerning advanced care planning and do-not-attempt-resuscitation orders should be standard of care, especially in elderly polymorbid patients [ 20 – 25 ].…”

“…Knowledge about the expected chances of survival with good neurofunctional recovery following a cardiac arrest can guide patients and physicians in this difficult decision-making process. The Good Outcome Following Attempted Resuscitation (GO-FAR) score is a pre-arrest CPM, which has shown potential as a tool to assess futility regarding cardiopulmonary resuscitation (CPR) and might thus be valuable to support code status discussions [ 16 , 17 ]. It predicts the chance of survival to hospital discharge with a favourable neurological outcome as measured by CPC in case of an in-hospital cardiac arrest [ 16 ].…”

Pre-arrest prediction of survival following in-hospital cardiac arrest: A systematic review of diagnostic test accuracy studies

“…Accordingly, several pre-arrest prediction rules have been developed over the years. 18,19 However, no systematic reviews have assessed the test accuracy of current pre-arrest prediction rules for IHCA. The International Liaison Committee on Resuscitation (ILCOR) task force on Education, Implementation, and Teams ranked the topic as a high priority and initiated this systematic review in collaboration with the Pediatric Life Support and Advanced Life Support task forces.…”

Futility in Cardiopulmonary Resuscitation of Pre-Hospital Emergency

“…With the proposed descriptions either too rigid or too vague to cover many aspects of medical care [11]. Futility is generally difficult to define, especially when dealing with CPR and other life-sustaining measures [11], so there are several definitions of futility in CPR [12]. But is the futility or assumption of the futility of CPR a cause not to perform this maneuver or not?…”