Can absence of cardiac activity on point-of-care echocardiography predict death in out-of-hospital cardiac arrest? A systematic review and meta-analysis
<h3>Aim</h3><p dir="ltr">The purpose of this systematic review and meta-analysis was to evaluate the accuracy of the absence of cardiac motion on point-of-care echocardiography (PCE) in predicting termination of resuscitation (TOR), short-term death (STD), and long-term d...
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| مؤلفون آخرون: | , , , , , |
| منشور في: |
2024
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| _version_ | 1864513544655994880 |
|---|---|
| author | Omar Albaroudi (16122240) |
| author2 | Bilal Albaroudi (16122219) Mahmoud Haddad (16122230) Manar E. Abdle-Rahman (18000591) Thirumoothy Samy Suresh Kumar (18000594) Robert David Jarman (18000597) Tim Harris (717778) |
| author2_role | author author author author author author |
| author_facet | Omar Albaroudi (16122240) Bilal Albaroudi (16122219) Mahmoud Haddad (16122230) Manar E. Abdle-Rahman (18000591) Thirumoothy Samy Suresh Kumar (18000594) Robert David Jarman (18000597) Tim Harris (717778) |
| author_role | author |
| dc.creator.none.fl_str_mv | Omar Albaroudi (16122240) Bilal Albaroudi (16122219) Mahmoud Haddad (16122230) Manar E. Abdle-Rahman (18000591) Thirumoothy Samy Suresh Kumar (18000594) Robert David Jarman (18000597) Tim Harris (717778) |
| dc.date.none.fl_str_mv | 2024-02-20T09:00:00Z |
| dc.identifier.none.fl_str_mv | 10.1186/s13089-024-00360-x |
| dc.relation.none.fl_str_mv | https://figshare.com/articles/journal_contribution/Can_absence_of_cardiac_activity_on_point-of-care_echocardiography_predict_death_in_out-of-hospital_cardiac_arrest_A_systematic_review_and_meta-analysis/29590322 |
| dc.rights.none.fl_str_mv | CC BY 4.0 info:eu-repo/semantics/openAccess |
| dc.subject.none.fl_str_mv | Biomedical and clinical sciences Cardiovascular medicine and haematology Clinical sciences Emergency medicine Resuscitation Cardiac arrest Ultrasound Echocardiography Point-of-care Death Survival PoCUS OHCA CPR |
| dc.title.none.fl_str_mv | Can absence of cardiac activity on point-of-care echocardiography predict death in out-of-hospital cardiac arrest? A systematic review and meta-analysis |
| dc.type.none.fl_str_mv | Text Journal contribution info:eu-repo/semantics/publishedVersion text contribution to journal |
| description | <h3>Aim</h3><p dir="ltr">The purpose of this systematic review and meta-analysis was to evaluate the accuracy of the absence of cardiac motion on point-of-care echocardiography (PCE) in predicting termination of resuscitation (TOR), short-term death (STD), and long-term death (LTD), in adult patients with cardiac arrest of all etiologies in out-of-hospital and emergency department setting.</p><h3>Methods</h3><p dir="ltr">A systematic review and meta-analysis was conducted based on PRISMA guidelines. A literature search in Medline, EMBASE, Cochrane, WHO registry, and ClinicalTrials.gov was performed from inspection to August 2022. Risk of bias was evaluated using QUADAS-2 tool. Meta-analysis was divided into medical cardiac arrest (MCA) and traumatic cardiac arrest (TCA). Sensitivity and specificity were calculated using bivariate random-effects, and heterogeneity was analyzed using I2 statistic.</p><h3>Results</h3><p dir="ltr">A total of 27 studies (3657 patients) were included in systematic review. There was a substantial variation in methodologies across the studies, with notable difference in inclusion criteria, PCE timing, and cardiac activity definition. In MCA (15 studies, 2239 patients), the absence of cardiac activity on PCE had a sensitivity of 72% [95% CI 62–80%] and specificity of 80% [95% CI 58–92%] to predict LTD. Although the low numbers of studies in TCA preluded meta-analysis, all patients who lacked cardiac activity on PCE eventually died.</p><h3>Conclusions</h3><p dir="ltr">The absence of cardiac motion on PCE for MCA predicts higher likelihood of death but does not have sufficient accuracy to be used as a stand-alone tool to terminate resuscitation. In TCA, the absence of cardiac activity is associated with 100% mortality rate, but low number of patients requires further studies to validate this finding. Future work would benefit from a standardized protocol for PCE timing and agreement on cardiac activity definition.</p><h2>Other Information</h2><p dir="ltr">Published in: The Ultrasound Journal<br>License: <a href="https://creativecommons.org/licenses/by/4.0" target="_blank">https://creativecommons.org/licenses/by/4.0</a><br>See article on publisher's website: <a href="https://dx.doi.org/10.1186/s13089-024-00360-x" target="_blank">https://dx.doi.org/10.1186/s13089-024-00360-x</a></p> |
| eu_rights_str_mv | openAccess |
| id | Manara2_5a4fa84812d0407bdee90dde1552ed3e |
| identifier_str_mv | 10.1186/s13089-024-00360-x |
| network_acronym_str | Manara2 |
| network_name_str | Manara2 |
| oai_identifier_str | oai:figshare.com:article/29590322 |
| publishDate | 2024 |
| repository.mail.fl_str_mv | |
| repository.name.fl_str_mv | |
| repository_id_str | |
| rights_invalid_str_mv | CC BY 4.0 |
| spelling | Can absence of cardiac activity on point-of-care echocardiography predict death in out-of-hospital cardiac arrest? A systematic review and meta-analysisOmar Albaroudi (16122240)Bilal Albaroudi (16122219)Mahmoud Haddad (16122230)Manar E. Abdle-Rahman (18000591)Thirumoothy Samy Suresh Kumar (18000594)Robert David Jarman (18000597)Tim Harris (717778)Biomedical and clinical sciencesCardiovascular medicine and haematologyClinical sciencesEmergency medicineResuscitationCardiac arrestUltrasoundEchocardiographyPoint-of-careDeath SurvivalPoCUSOHCACPR<h3>Aim</h3><p dir="ltr">The purpose of this systematic review and meta-analysis was to evaluate the accuracy of the absence of cardiac motion on point-of-care echocardiography (PCE) in predicting termination of resuscitation (TOR), short-term death (STD), and long-term death (LTD), in adult patients with cardiac arrest of all etiologies in out-of-hospital and emergency department setting.</p><h3>Methods</h3><p dir="ltr">A systematic review and meta-analysis was conducted based on PRISMA guidelines. A literature search in Medline, EMBASE, Cochrane, WHO registry, and ClinicalTrials.gov was performed from inspection to August 2022. Risk of bias was evaluated using QUADAS-2 tool. Meta-analysis was divided into medical cardiac arrest (MCA) and traumatic cardiac arrest (TCA). Sensitivity and specificity were calculated using bivariate random-effects, and heterogeneity was analyzed using I2 statistic.</p><h3>Results</h3><p dir="ltr">A total of 27 studies (3657 patients) were included in systematic review. There was a substantial variation in methodologies across the studies, with notable difference in inclusion criteria, PCE timing, and cardiac activity definition. In MCA (15 studies, 2239 patients), the absence of cardiac activity on PCE had a sensitivity of 72% [95% CI 62–80%] and specificity of 80% [95% CI 58–92%] to predict LTD. Although the low numbers of studies in TCA preluded meta-analysis, all patients who lacked cardiac activity on PCE eventually died.</p><h3>Conclusions</h3><p dir="ltr">The absence of cardiac motion on PCE for MCA predicts higher likelihood of death but does not have sufficient accuracy to be used as a stand-alone tool to terminate resuscitation. In TCA, the absence of cardiac activity is associated with 100% mortality rate, but low number of patients requires further studies to validate this finding. Future work would benefit from a standardized protocol for PCE timing and agreement on cardiac activity definition.</p><h2>Other Information</h2><p dir="ltr">Published in: The Ultrasound Journal<br>License: <a href="https://creativecommons.org/licenses/by/4.0" target="_blank">https://creativecommons.org/licenses/by/4.0</a><br>See article on publisher's website: <a href="https://dx.doi.org/10.1186/s13089-024-00360-x" target="_blank">https://dx.doi.org/10.1186/s13089-024-00360-x</a></p>2024-02-20T09:00:00ZTextJournal contributioninfo:eu-repo/semantics/publishedVersiontextcontribution to journal10.1186/s13089-024-00360-xhttps://figshare.com/articles/journal_contribution/Can_absence_of_cardiac_activity_on_point-of-care_echocardiography_predict_death_in_out-of-hospital_cardiac_arrest_A_systematic_review_and_meta-analysis/29590322CC BY 4.0info:eu-repo/semantics/openAccessoai:figshare.com:article/295903222024-02-20T09:00:00Z |
| spellingShingle | Can absence of cardiac activity on point-of-care echocardiography predict death in out-of-hospital cardiac arrest? A systematic review and meta-analysis Omar Albaroudi (16122240) Biomedical and clinical sciences Cardiovascular medicine and haematology Clinical sciences Emergency medicine Resuscitation Cardiac arrest Ultrasound Echocardiography Point-of-care Death Survival PoCUS OHCA CPR |
| status_str | publishedVersion |
| title | Can absence of cardiac activity on point-of-care echocardiography predict death in out-of-hospital cardiac arrest? A systematic review and meta-analysis |
| title_full | Can absence of cardiac activity on point-of-care echocardiography predict death in out-of-hospital cardiac arrest? A systematic review and meta-analysis |
| title_fullStr | Can absence of cardiac activity on point-of-care echocardiography predict death in out-of-hospital cardiac arrest? A systematic review and meta-analysis |
| title_full_unstemmed | Can absence of cardiac activity on point-of-care echocardiography predict death in out-of-hospital cardiac arrest? A systematic review and meta-analysis |
| title_short | Can absence of cardiac activity on point-of-care echocardiography predict death in out-of-hospital cardiac arrest? A systematic review and meta-analysis |
| title_sort | Can absence of cardiac activity on point-of-care echocardiography predict death in out-of-hospital cardiac arrest? A systematic review and meta-analysis |
| topic | Biomedical and clinical sciences Cardiovascular medicine and haematology Clinical sciences Emergency medicine Resuscitation Cardiac arrest Ultrasound Echocardiography Point-of-care Death Survival PoCUS OHCA CPR |