Cardiac arrest and cardiopulmonary resuscitation outcome reports: update and simplification of the Utstein templates for resuscitation registries.

Jacobs, Ian; Nadkarni, Vinay; Bahr, J.; Berg, Robert A.; Billi, John E.; Bossaert, Leo; Cassan, Pascal; Coovadia, Ashraf; D’Este, Kate; Finn, Judith; Halperin, Henry R.; Handley, Anthony J.; Herlitz, Johan; Hickey, Robert W.; Idris, Ahamed H.; Kloeck, Walter; Larkin, Gregory Luke; Mancini, Mary E.; Mason, Pip; Mears, Gregory; Monsieurs, Koenraad G.; Montgomery, William; Morley, Peter; Nichol, Graham; Nolan, Jerry P.; Okada, Kazuo; Perlman, Jeffrey M.; Shüster, Michael; Steen, Petter Andreas; Sterz, Fritz; Tibballs, James; Timerman, Sérgio; Truitt, Tanya Lane; Zideman, David

doi:10.1016/j.resuscitation.2004.09.008

Cited by 1,019 publications

(832 citation statements)

References 28 publications

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“…[16,17,23,27] However, the clinical significance of this outcome is uncertain with a number of studies reporting either no improvement or a decrease in survival to hospital discharge or a decrease in favourable neurological outcome. [18,19,26,30]…”

Section: Discussionmentioning

confidence: 99%

“…In concordance with the Utstein Style guidelines for reporting data from out-of-hospital cardiac arrest,[22,23] the primary outcomes to be analyzed in recruited studies are survival to hospital discharge and neurological performance. A secondary outcome examined will be ROSC.…”

Section: Methodsmentioning

confidence: 99%

“…Neurologically intact survival (a combination of the Utstein variables of neurological outcome at discharge from hospital and survival to hospital discharge) is generally accepted as the most relevant outcome. [22,23] This will be reflected in the outcome measures of the included studies in this review. This review was conducted to address the knowledge deficit regarding epinephrine in OHCA.…”

Section: Introductionmentioning

confidence: 99%

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Epinephrine in out-of-hospital cardiac arrest:A critical review

Reardon¹,

Magee²

2013

World Journal of Emergency Medicine

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BACKGROUND:Epinephrine is recommended in advanced cardiac life support guidelines for use in adult cardiac arrest, and has been used in cardiopulmonary resuscitation since 1896. Yet, despite its long time use and incorporation into guidelines, epinephrine suffers from a paucity of evidence regarding its influence on survival. This critical review was conducted to address the knowledge deficit regarding epinephrine in out-of-hospital cardiac arrest and its effect on return of spontaneous circulation, survival to hospital discharge, and neurological performance.METHODS:The EMBASE and MEDLINE (through the Pubmed interface) databases, and the Cochrane library were searched with the key words “epinephrine”, “cardiac arrest” and variations of these terms. Original research studies concerning epinephrine use in adult, out-of-hospital cardiac arrest were selected for further review.RESULTS:The search yielded nine eligible studies based on inclusion criteria. This includes five prospective cohort studies, one retrospective cohort study, one survival analysis, one case control study, and one RCT. The evidence clearly establishes an association between epinephrine and increased return of spontaneous circulation, the data were conflicting concerning survival to hospital discharge and neurological outcome.CONCLUSIONS:The results of this review exhibit the paucity of evidence regarding the use of epinephrine in out of hospital cardiac arrest. There is currently insufficient evidence to support or reject its administration during resuscitation. Larger sample, placebo controlled, double blind, randomized control trials need to be performed to definitively establish the effect of epinephrine on both survival to hospital discharge and the neurological outcomes of treated patients.

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Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Epinephrine in out-of-hospital cardiac arrest:A critical review

Reardon¹,

Magee²

2013

World Journal of Emergency Medicine

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“…CARES is a prospective registry established in the United States in 2005 that collects demographic, dispatch, prehospital EMS, and hospital‐based data on patients who suffer OHCA. CARES organizes information according to the Utstein template using standard data element definitions 14. HeartRescue collected information through emergency dispatch information, EMS reports, hospital records, and vital statistics.…”

Section: Methodsmentioning

confidence: 99%

Multistate 5‐Year Initiative to Improve Care for Out‐of‐Hospital Cardiac Arrest: Primary Results From the HeartRescue Project

Diepen

Girotra

Abella

et al. 2017

JAHA

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BackgroundThe HeartRescue Project is a multistate public health initiative focused on establishing statewide out‐of‐hospital cardiac arrest (OHCA) systems of care to improve case capture and OHCA care in the community, by emergency medical services (EMS), and at hospital level.Methods and ResultsFrom 2011 to 2015 in the 5 original HeartRescue states, all adults with EMS–treated OHCA due to a presumed cardiac cause were included. In an adult population of 32.8 million, a total of 64 988 OHCAs—including 10 046 patients with a bystander‐witnessed OHCA with a shockable rhythm—were treated by 330 EMS agencies. From 2011 to 2015, the case‐capture rate for all‐rhythm OHCA increased from an estimated 39.0% (n=6762) to 89.2% (n=16 103; P<0.001 for trend). Overall survival to hospital discharge was 11.4% for all rhythms and 34.0% in the subgroup with bystander‐witnessed OHCA with a shockable rhythm. We observed modest temporal increases in bystander cardiopulmonary resuscitation (41.8–43.5%, P<0.001 for trend) and bystander automated external defibrillator application (3.2–5.6%, P<0.001 for trend) in the all‐rhythm group, although there were no temporal changes in survival. There were marked all‐rhythm survival differences across the 5 states (8.0–16.1%, P<0.001) and across participating EMS agencies (2.7–26.5%, P<0.001).ConclusionsIn the initial 5 years, the HeartRescue Project developed a population‐based OHCA registry and improved statewide case‐capture rates and some processes of care, although there were no early temporal changes in survival. The observed survival variation across states and EMS systems presents a future challenge to elucidate the characteristics of high‐performing systems with the goal of improving OHCA care and survival.

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“…CPC 1 and 2 were defined as good neurological recovery. The CPC scores were further dichotomized into good (CPC 1 or 2) and poor (CPC 3, 4, or 5) outcomes 25, 26. If the patients were discharged from the hospital or transferred out to rehabilitation hospitals, the institutional researchers collected the information by telephone 11, 16…”

Section: Methodsmentioning

confidence: 99%

Mechanical Cardiopulmonary Resuscitation and Hospital Survival Among Adult Patients With Nontraumatic Out‐of‐Hospital Cardiac Arrest Attending the Emergency Department: A Prospective, Multicenter, Observational Study in Japan (SOS‐KANTO [Survey of Survivors after Out‐of‐Hospital Cardiac Arrest in Kanto Area] 2012 Study)

Hayashida

Tagami

Fukuda

et al. 2017

JAHA

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BackgroundMechanical cardiopulmonary resuscitation (mCPR) for patients with out‐of‐hospital cardiac arrest attending the emergency department has become more widespread in Japan. The objective of this study is to determine the association between the mCPR in the emergency department and clinical outcomes.Methods and ResultsIn a prospective, multicenter, observational study, adult patients with out‐of‐hospital cardiac arrest with sustained circulatory arrest on hospital arrival were identified. The primary outcome was survival to hospital discharge. The secondary outcomes included a return of spontaneous circulation and successful hospital admission. Multivariate analyses adjusted for potential confounders and within‐institution clustering effects using a generalized estimation equation were used to analyze the association of the mCPR with outcomes. Between January 1, 2012 and March 31, 2013, 6537 patients with out‐of‐hospital cardiac arrest were eligible; this included 5619 patients (86.0%) in the manual CPR group and 918 patients (14.0%) in the mCPR group. Of those patients, 28.1% (1801/6419) showed return of spontaneous circulation in the emergency department, 20.4% (1175/5754) had hospital admission, 2.6% (168/6504) survived to hospital discharge, and 1.2% (75/6419) showed a favorable neurological outcome at 1 month after admission. Multivariate analyses revealed that mCPR was associated with a decreased likelihood of survival to hospital discharge (adjusted odds ratio, 0.40; 95% confidence interval, 0.20–0.78; P=0.005), return of spontaneous circulation (adjusted odds ratio, 0.71; 95% confidence interval, 0.53–0.94; P=0.018), and hospital admission (adjusted odds ratio, 0.57; 95% confidence interval, 0.40–0.80; P=0.001).ConclusionsAfter accounting for potential confounders, the mCPR in the emergency department was associated with decreased likelihoods of good clinical outcomes after adult nontraumatic out‐of‐hospital cardiac arrest. Further studies are needed to clarify circumstances in which mCPR may benefit these patients.

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Cardiac arrest and cardiopulmonary resuscitation outcome reports: update and simplification of the Utstein templates for resuscitation registries.

Cited by 1,019 publications

References 28 publications

Epinephrine in out-of-hospital cardiac arrest:A critical review

Epinephrine in out-of-hospital cardiac arrest:A critical review

Multistate 5‐Year Initiative to Improve Care for Out‐of‐Hospital Cardiac Arrest: Primary Results From the HeartRescue Project

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