Trial reportResuscitation2016
Association of early withdrawal of life-sustaining therapy for perceived neurological prognosis with mortality after cardiac arrest.
Trial report in Resuscitation, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT07002294 (The Effect of SPecialty cAre on Recovery From Cardiac Arrest Trial), which is not on this map. Cited by 196 papers, 7 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
The Effect of SPecialty cAre on Recovery From Cardiac Arrest Trial (the SPARC Trial)
Who cites it
196 citing papers in PubMed, 7 syntheses or guidelines pooled it, 417 citations in OpenAlex.
- European Resuscitation Council and European Society of Intensive Care Medicine guidelines 2025: post-resuscitation care.Intensive care medicine · 2025Guideline
- Predicting neurological outcome in adult patients with cardiac arrest: systematic review and meta-analysis of prediction model performance.Critical care (London, England) · 2022Pooled it
- 2020 Korean Guidelines for Cardiopulmonary Resuscitation. Part 5. Post-cardiac arrest care.Clinical and experimental emergency medicine · 2021Guideline
- Clinical Predictive Models of Sudden Cardiac Arrest: A Survey of the Current Science and Analysis of Model Performances.Journal of the American Heart Association · 2020Pooled it
- Estimating the False Positive Rate of Absent Somatosensory Evoked Potentials in Cardiac Arrest Prognostication.Critical care medicine · 2018Pooled it
- The efficacy and safety of pre-hospital cooling after out-of-hospital cardiac arrest: a systematic review and meta-analysis.Critical care (London, England) · 2018Pooled it
- The rate of brain death and organ donation in patients resuscitated from cardiac arrest: a systematic review and meta-analysis.Intensive care medicine · 2016Pooled it
- Trial
- Factors Associated with Early Withdrawal of Life-Sustaining Treatments After Out-of-Hospital Cardiac Arrest: A Subanalysis of a Randomized Trial of Prehospital Therapeutic Hypothermia.Neurocritical care · 2023Trial
- Trial
- Impact of a Specialized Care Pathway for ICU Patients With Disorders of Consciousness: Observational Insights From an Expert Center.European journal of neurology · 2026Observational
- Neurological prognostication after cardiac arrest: evidence review and institutional protocol proposal.Arquivos de neuro-psiquiatria · 2026Review
- Serial Changes in CSF Volume Proportion on Brain CT and 6-Month Neurologic Outcomes After Cardiac Arrest: A 72-96-h Landmark Cohort Study.Journal of clinical medicine · 2026Article
- Impact of Mandatory Clinical Ethics Consultation for Neurocritically Ill Patients.Journal of bioethical inquiry · 2026Article
- Prognostic Significance of EEG Patterns in Post-Cardiac Arrest Coma: A Multicenter Retrospective Cohort Study of 1,000 Patients.Neurology open access · 2026Article
- Clinicians' Approaches to Prognostication After Traumatic Brain Injury and Cardiac Arrest: A Multi-Hospital, Qualitative Study.Neurocritical care · 2026Article
- Neuroprognostication after cardiac arrest in patients without withdrawal of life-sustaining therapy: a prospective observational multicenter study.Critical care (London, England) · 2026Observational
- Outcomes and Decision-Making Following Out-of-Hospital Cardiac Arrest Within a Multidisciplinary Neuroprognostication Pathway in a Tertiary Cardiac Intensive Care Unit.Journal of clinical medicine · 2026Article
- Role of Neurophysiologic Testing in Prognostication of Hypoxic-Ischemic Encephalopathy.Journal of clinical neurophysiology : official publication of the American Electroencephalographic Society · 2026Review
- Timing matters: sex differences in treatment limitation decisions in intensive care.Critical care (London, England) · 2026Article
136 more citing papers are in PubMed but not listed here.
Corrections and comments
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Authors and funding
14 authors at 9 institutions in 3 countries.
Funding
Abstract
backgroundWithdrawing life-sustaining therapy because of perceived poor neurological prognosis (WLST-N) is a common cause of hospital death after out-of-hospital cardiac arrest (OHCA). Although current guidelines recommend against WLST-N before 72h (WLST-N<72), this practice is common and may increase mortality. We sought to quantify these effects.
methodsIn a secondary analysis of a multicenter OHCA trial, we evaluated survival to hospital discharge and survival with favorable functional status (modified Rankin Score ≤3) in adults alive >1h after hospital admission. Propensity score modeling the probability of exposure to WLST-N<72 based on pre-exposure covariates was used to match unexposed subjects with those exposed to WLST-N<72. We determined the probability of survival and functionally favorable survival in the unexposed matched cohort, fit adjusted logistic regression models to predict outcomes in this group, and then used these models to predict outcomes in the exposed cohort. Combining these findings with current epidemiologic statistics we estimated mortality nationally that is associated with WLST-N<72.
resultsOf 16,875 OHCA subjects, 4265 (25%) met inclusion criteria. WLST-N<72 occurred in one-third of subjects who died in-hospital. Adjusted analyses predicted that exposed subjects would have 26% survival and 16% functionally favorable survival if WLST-N<72 did not occur. Extrapolated nationally, WLST-N<72 may be associated with mortality in approximately 2300 Americans each year of whom nearly 1500 (64%) might have had functional recovery.
conclusionsAfter OHCA, death following WLST-N<72 may be common and is potentially avoidable. Reducing WLST-N<72 has national public health implications and may afford an opportunity to decrease mortality after OHCA.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.