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Neurologic prognosis after cardiac arrest.

To the Editor: We are concerned that Young (Aug. 6 issue)1 did not emphasize the considerable help provided by the clinical history in predicting the prognosis for a patient after cardiac arrest. Elements of the clinical history — such as the location of the arrest (home or outdoors), the presence or absence of witnesses, and the chronology (delays in delivery of cardiopulmonary resuscitation and the first therapeutic shock) — are generally easy to collect and are strongly associated with outcomes.2,3 Therefore, such information may assist clinicians in making the difficult decision to withdraw life support. In these situations, it seems to us that the value of basic medical practices should not be underestimated.