Does early withdrawal of life-sustaining treatment increase mortality after cardiac arrest?

The majority of patients who are admitted to the hospital after a successful resuscitation from out-of-hospital cardiac arrest (OHCA) die before hospital discharge. Most of these deaths are due to severe hypoxic–ischaemic brain injury1 and occur after withdrawal of life sustaining treatment (WLST) because a poor neurological prognosis is expected. When prognosticating a poor neurological outcome in patients who are unconscious after resuscitation from cardiac arrest the risk of a falsely pessimistic prediction should be minimised in order to avoid an inappropriate WLST. Since even the most robust predictors of poor neurological outcome are not 100% specific (e.g. some false positive may be expected), an integrated approach using multiple prognostic tests is recommended.