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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
  1. Tiffany Patterson1,
  2. Gavin D Perkins2,
  3. Jubin Joseph1,
  4. Karen Wilson1,
  5. Laura Van Dyck3,
  6. Steven Robertson3,
  7. Hanna Nguyen1,
  8. Hannah McConkey1,
  9. Mark Whitbread4,
  10. Rachael Fothergill4,
  11. Joanne Nevett4,
  12. Miles Dalby5,
  13. Roby Rakhit6,
  14. Philip MacCarthy7,
  15. Divaka Perera1,
  16. Jerry P Nolan8,
  17. Simon R Redwood1
  1. 1Cardiovascular Division, The Rayne Institute BHF Centre of Research Excellence, King’s College London, St. Thomas’ Hospital, London
  2. 2Warwick Clinical Trials Unit and Heart of England NHS Foundation Trust, Warwick Medical School, University of Warwick, Coventry
  3. 3London School of Hygiene and Tropical Medicine Clinical Trials Unit, London
  4. 4London Ambulance Service, London
  5. 5Department of Cardiology, Royal Brompton and Harefield NHS Foundation Trust, Middlesex
  6. 6Department of Cardiology, Royal Free NHS Foundation Trust, London
  7. 7Department of Cardiology, King’s College Hospital NHS Foundation Trust, London
  8. 8School of Clinical Sciences, University of Bristol and Department of Anaesthesia, Royal United Hospital, Bath, UK


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.

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