Korean Cardiac Arrest Research Consortium (KoCARC): rationale, development, and implementation

Abstract

ObjectiveThis study aimed to describe the conceptualization, development, and implementation processes of the newly established Korean Cardiac Arrest Resuscitation Consortium (KoCARC) to improve out-of-hospital cardiac arrest (OHCA) outcomes.MethodsThe KoCARC was established in 2014 by recruiting hospitals willing to participate voluntarily. To enhance professionalism in research, seven research committees, the Epidemiology and Preventive Research Committee, Community Resuscitation Research Committee, Emergency Medical System Resuscitation Research Committee, Hospital Resuscitation Research Committee, Hypothermia and Postresuscitation Care Research Committee, Cardiac Care Resuscitation Committee, and Pediatric Resuscitation Research Committee, were organized under a steering committee. The KoCARC registry was developed with variables incorporated in the currently existing regional OHCA registries and Utstein templates and were collected via a web-based electronic database system. The KoCARC study population comprises patients visiting the participating hospitals who had been treated by the emergency medical system for OHCA presumed to have a cardiac etiology.ResultsA total of 62 hospitals volunteered to participate in the KoCARC, which captures 33.0% of the study population in Korea. Web-based data collection started in October 2015, and to date (December 2016), there were 3,187 cases compiled in the registry collected from 32 hospitals.ConclusionThe KoCARC is a self-funded, voluntary, hospital-based collaborative research network providing high level evidence in the field of OHCA and resuscitation. This paper will serve as a reference for subsequent KoCARC manuscripts and for data elements collected in the study.

Comparing the neurologic outcomes of patients with out-of-hospital cardiac arrest according to prehospital advanced airway management method and transport time interval

“…The KoCARC registry excluded OHCA patients with terminal illnesses documented in their medical records as well as those under hospice care, those who were pregnant, and those with "do not resuscitate" directives. Furthermore, we also excluded the following groups: patients with OHCA verifiably caused by nonmedical etiologies such as trauma, drowning, poisoning, burn, asphyxia, and hanging 17 ; patients who transferred from other hospitals and had insufficient prehospital time variables and/or unclear prehospital airway management methods; and patients who experienced cardiac arrest during transport to the hospital (whether in an ambulance or otherwise). In South Korea, if three or more EMTs are dispatched to the location of a patient with cardiac arrest, they are required to perform ETI or use SGAs while administering effective chest compressions in the field according to field treatment guidelines.…”

“…The quality management committee provides feedback regarding quality management processes to the research coordinators and investigators. 17…”

“…We used the following a favorable registry core variables: (1) patient demographics (i.e., sex, age, medical history of hypertension, diabetes, and dyslipidemia); (2) community resuscitation (i.e., 'witnessed' status, bystander CPR, and location of cardiac arrest occurrence); (3) EMS resuscitation (i.e., initial electrocardiogram rhythm, prehospital defibrillation, prehospital epinephrine administration, prehospital ROSC, elapsed time from the initial call to ambulance arrival at the scene [response time interval], elapsed time from arrival at the scene to departure [scene time interval], and elapsed time from departure to arrival at the emergency department [TTI]); and (4) hospital resuscitation and postresuscitation care (i.e., performed extracorporeal membrane oxygenation, coronary angiography, and target temperature management). 17…”

“…The present study aimed to investigate the association between the prehospital airway management method (BVM, ETI, or SGA) and neurologic outcomes in patients with OHCA according to TTI using data from the Korean Cardiac Arrest Research Consortium (KoCARC) database. 17…”

Cardiac arrest and sudden cardiac death registries: a systematic review of global coverage

“…Preliminary reports suggest that patterns of SCD and their management may vary with geography and ethnicity. From several Asian CA registries,19 28 29 it would appear that Asian countries may have lower rates of VT/VF as presenting rhythm in OHCA and lower rates of survival to hospital discharge 28. The Douala-SCD registry reported that there were no survivors of OHCA during the entire recruitment period, reflecting the challenges of CA management in low-resource settings.…”