RT Journal Article
SR Electronic
T1 13 A randomised trial of expedited transfer to a cardiac arrest centre for non-ste out-of-hospital cardiac arrest: arrest
JF Heart
JO Heart
FD BMJ Publishing Group Ltd and British Cardiovascular Society
SP A7
OP A8
DO 10.1136/heartjnl-2018-BCIS.13
VO 104
IS Suppl 1
A1 Tiffany Patterson
A1 Gavin D Perkins
A1 Jubin Joseph
A1 Karen Wilson
A1 Laura Van Dyck
A1 Steven Robertson
A1 Hanna Nguyen
A1 Hannah McConkey
A1 Mark Whitbread
A1 Rachael Fothergill
A1 Joanne Nevett
A1 Miles Dalby
A1 Roby Rakhit
A1 Philip MacCarthy
A1 Divaka Perera
A1 Jerry P Nolan
A1 Simon R Redwood
YR 2018
UL http://heart.bmj.com/content/104/Suppl_1/A7.2.abstract
AB 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.