Maayke Hunfeld

122 Chapter 4 Timing of WLST decision making and rationale, and also timing of the actual WLST and death were retrieved for non-survivors. Timing was defined as number of days after the CPR-event: within 24 hours = 0 day, between 24-48 hours= 1 day, between 48-72 hours = 2 days, etc. In our center (as in all PICUs of The Netherlands) WLST decision-making is done by the medical team, not the parents. In case parents do not agree, a second opinion is often organized (i.e., clinicians from another hospital, preferably an expert in this field). To define prearrest neurologic functioning (in children > 6 mo), the PCPC score was used (16). Both the medical student (JH) and pediatric neurologist (MH) determined the PCPC score independently (based on notes in the medical records). In the case of disagreement, consensus was achieved. The SES was estimated by using the ‘Status Score’ (17). We used radiology reports to reviewMRI, CT and ultrasound brain imaging findings. SSEP results were obtained from the neurophysiology reports. An independent clinical neurophysiologist reviewed the EEGs (routine and or continuous) and was blinded to outcome. Neurologic examination findings were obtained from documentation in physician and nursing medical records. Data analysis Categorical variables were described using counts and percentages. Continuous variables were described with descriptive statistics presented as mean and SD, or as median and interquartile range (IQR, 25 – 75 th percentile) if data were not normally distributed. To determine differences between survivors and nonsurvivors, and between WLST-Neuro and BD patients, chi-square, Fisher’s exact tests or linear-by-linear chi- square association tests were used for categorical variables, and Mann-Whitney tests or independent sample t tests were used for continuous variables. Missing data were handled by performing complete case analyses. All statistical tests were two-sided with a significance level of 0.05, but a Bonferroni-adjusted significance level of 0.017 was used for comparisons that were performed for each of three time points. Results Between January 2012 and December 2017, 113 children were admitted to the PICU of the Erasmus MC – Sophia Children’s Hospital following ROC after OHCA ( Supplemental Fig. 1 , Supplemental Digital Content 1, http://links.lww.com/PCC/B538 ). The most common causes of OHCA were drowning (21%) and arrhythmia (17%) ( Table 1 ).