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13 A randomised trial of expedited transfer to a cardiac arrest centre for non-ste out-of-hospital cardiac arrest : arrest
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Patterson, Tiffany, Perkins, Gavin D., Joseph, Jubin, Wilson, Karen, Dyck, Laura Van, Robertson, Steven, Nguyen, Hanna, McConkey, Hannah, Whitbread, Mark, Fothergill, Rachael, Nevett, Joanne, Dalby, Miles, Rakhit, Roby, MacCarthy, Philip, Perera, Divaka, Nolan, Jerry P and Redwood, Simon R (2018) 13 A randomised trial of expedited transfer to a cardiac arrest centre for non-ste out-of-hospital cardiac arrest : arrest. Heart, 104 (1). A7-A8. doi:10.1136/heartjnl-2018-BCIS.13 ISSN 1355-6037.
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Official URL: http://dx.doi.org/10.1136/heartjnl-2018-BCIS.13
Abstract
Background: Wide variation exists in inter-hospital survival from OHCA. Regionalisation of care into cardiac arrest centres (CAC) may improve this. We report a pilot randomised trial of expedited transfer to a CAC following OHCA without ST-elevation. The objective was to assess the feasibility of performing a large-scale RCT.
Methods: Adult witnessed VF OHCA of presumed cardiac cause were randomised 1:1 to either: (1) intervention: expedited transfer to a CAC for goal-directed therapy including access to immediate reperfusion, or (2) control: current standard of care involving delivery to the geographically closest hospital. The feasibility of randomisation, protocol adherence and data collection of the primary (30 day all-cause mortality) and secondary (cerebral performance category (CPC)) and in-hospital major cardiovascular and cerebrovascular events (MACCE) clinical outcome measures were assessed.
Results: Between Nov 2014 and April 2016, 118 cases were screened, of which 63 patients (53%) met eligibility criteria and 40 of the 63 patients (63%) were randomised. There were no protocol deviations in the treatment arm. Data collection of primary and secondary outcomes was achieved in 83%. There was no difference in baseline characteristics between the groups: 30 day mortality (Int 9/18, 50% vs Control 6/15, 40%; p=0.73), CPC 1/2 (Int: 9/18, 50% vs Control 7/14, 50%; p>0.99) or MACCE (Int: 9/18, 50% vs Control 6/15, 40%; p=0.73).
Conclusions: These findings support the feasibility of conducting a large-scale RCT to address a remaining uncertainty in post-arrest care.
Item Type: | Journal Article | ||||||
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Subjects: | R Medicine > R Medicine (General) | ||||||
Divisions: | Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School > Clinical Trials Unit Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School > Health Sciences Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School |
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Journal or Publication Title: | Heart | ||||||
Publisher: | BMJ | ||||||
ISSN: | 1355-6037 | ||||||
Book Title: | Abstracts | ||||||
Official Date: | 25 January 2018 | ||||||
Dates: |
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Volume: | 104 | ||||||
Number: | 1 | ||||||
Page Range: | A7-A8 | ||||||
DOI: | 10.1136/heartjnl-2018-BCIS.13 | ||||||
Status: | Peer Reviewed | ||||||
Publication Status: | Published | ||||||
Access rights to Published version: | Restricted or Subscription Access | ||||||
Conference Paper Type: | Other | ||||||
Title of Event: | Meeting of the British-Cardiovascular-Intervention-Society | ||||||
Type of Event: | Conference | ||||||
Location of Event: | Royal Coll Phys London, London, England | ||||||
Date(s) of Event: | 30 Nov 2017 |
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