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首页> 外文期刊>The American journal of emergency medicine >Applicability of the prehospital termination of resuscitation rule in an area dense with hospitals in Tokyo: A single-center, retrospective, observational study: Is the pre hospital TOR rule applicable in Tokyo?
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Applicability of the prehospital termination of resuscitation rule in an area dense with hospitals in Tokyo: A single-center, retrospective, observational study: Is the pre hospital TOR rule applicable in Tokyo?

机译：院前终止复苏规则在东京医院密集地区的适用性：单中心，回顾性观察研究：院前TOR规则在东京是否适用？

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Background It is unclear whether the prehospital termination of resuscitation (TOR) rule is applicable in specific situations such as in areas extremely dense with hospitals. Objectives The objective of the study is to assess whether the prehospital TOR rule is applicable in the emergency medical services system in Japan, specifically, in an area dense with hospitals in Tokyo. Methods This study was a retrospective, observational analysis of a cohort of adult out-of-hospital cardiopulmonary arrest (OHCA) patients who were transported to the University of Tokyo Hospital from April 1, 2009, to March 31, 2011. Results During the study period, 189 adult OHCA patients were enrolled. Of the 189 patients, 108 patients met the prehospital TOR rule. The outcomes were significantly worse in the prehospital TOR rule-positive group than in the prehospital TOR-negative group, with 0.9% vs 11.1% of patients, respectively, surviving until discharge (relative risk [RR], 1.11; 95% confidence interval [CI], 1.03-1.21; P =.0020) and 0.0% vs 7.4% of patients, respectively, discharged with a favorable neurologic outcome (RR, 1.08; 95% CI, 1.02-1.15; P =.0040). The prehospital TOR rule had a positive predictive value (PPV) of 99.1% (95% CI, 96.3-99.8) and a specificity of 90.0% (95% CI, 60.5-98.2) for death and a PPV of 100.0% (95% CI, 97.9-100.0) and a specificity of 100.0% (95% CI, 61.7-100.0) for an unfavorable neurologic outcome. Conclusions This study suggested that the prehospital TOR rule predicted unfavorable outcomes even in an area dense with hospitals in Tokyo and might be helpful for identifying the OHCA patients for whom resuscitation efforts would be fruitless.
机译：背景技术目前尚不清楚院前终止复苏（TOR）规则是否适用于特定情况，例如在医院密集的地区。目的研究的目的是评估院前TOR规则是否适用于日本的紧急医疗服务系统，特别是在东京医院密集的地区。方法本研究是对从2009年4月1日至2011年3月31日转入东京大学医院的成人院外心肺骤停（OHCA）患者的回顾性观察分析。在此期间，招募了189名成人OHCA患者。在189例患者中，有108例符合院前TOR规则。院前TOR规则阳性组的结果明显比院前TOR阴性组的结果差，分别为0.9％和11.1％的患者存活至出院（相对风险[RR]为1.11; 95％的置信区间[ CI]，1.03-1.21; P = .0020）和分别有0.0％和7.4％的患者出院，神经系统结局良好（RR，1.08; 95％CI，1.02-1.15; P = .0040）。院前TOR规则的阳性预测值（PPV）为99.1％（95％CI，96.3-99.8），死亡特异性为90.0％（95％CI，60.5-98.2），PPV为100.0％（95％） CI为97.9-100.0），对神经系统不良结局的特异性为100.0％（95％CI为61.7-100.0）。结论这项研究表明，即使在东京医院密集的地区，院前TOR规则也预示了不良结局，这可能有助于确定复苏努力无效的OHCA患者。

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