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Does care at a cardiac arrest centre improve outcome after out-of-hospital cardiac arrest? – A systematic review
Open accessAbstract
Aim To perform a systematic review to answer 'In adults with attempted resuscitation after non-traumatic cardiac arrest does care at a specialised cardiac arrest centre (CAC) compared to care in a healthcare facility not designated as a specialised cardiac arrest centre improve patient outcomes?' Methods The PRISMA guidelines were followed. We searched bibliographic databases (Embase, MEDLINE and the Cochrane Library (CENTRAL)) from inception to 1st August 2018. Randomised controlled trials (RCTs) and non-randomised studies were eligible for inclusion. Two reviewers independently scrutinized studies for relevance, extracted data and assessed quality of studies. Risk of bias of studies and quality of evidence were assessed using ROBINS-I tool and GRADEpro respectively. Primary outcomes were survival to 30 days with favourable neurological outcomes and survival to hospital discharge with favourable neurological outcomes. Secondary outcomes were survival to 30 days, survival to hospital discharge and return of spontaneous circulation (ROSC) post-hospital arrival for patients with ongoing resuscitation. This systematic review was registered in PROSPERO (CRD 42018093369) RESULTS: We included data from 17 observational studies on out-of-hospital cardiac arrest (OHCA) patients in meta-analyses. Overall, the certainty of evidence was very low. Pooling data from only adjusted analyses, care at CAC was not associated with increased likelihood of survival to 30 days with favourable neurological outcome (OR 2.92, 95% CI 0.68-12.48) and survival to 30 days (OR 2.14, 95% CI 0.73-6.29) compared to care at other hospitals. Whereas patients cared for at CACs had improved survival to hospital discharge with favourable neurological outcomes (OR 2.22, 95% CI 1.74-2.84) and survival to hospital discharge (OR 1.85, 95% CI 1.46-2.34). Conclusions Very low certainty of evidence suggests that post-cardiac arrest care at CACs is associated with improved outcomes at hospital discharge. There remains a need for high quality data to fully elucidate the impact of CACs.
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“A key concern is that respondents may be systematically different to non-respondents. 310”
From European Resuscitation Council Guidelines 2021: Ethics of resuscitation and end of life decisions (2021) · cites this paper as [310]
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European Resuscitation Council Guidelines 2021: Adult advanced life support
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Self-citationNolan, J. P., Soar, J., Cariou, A., Cronberg, T., Moulaert, V. R. M., Deakin, C. D., Böttiger, B. W., Friberg, H., Sunde, K., & Sandroni, C. (2015) · Intensive Care Medicine · doi:10.1007/s00134-015-4051-3 · Cited by 950
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“The most recent data from EuReCa TWO estimates average survival of 8% (range 0% 18%).1 In recent years, survival rates have also been reported from individual European countries; England, 7.9%;16 France 4.9%;64 Spain 13%;20 Germany 13.2%; (https://www.reanimationsregister. de/downloads/oeffentliche-jahresberichte/rett…”
MethodInfluentialNolan, J. P., Sandroni, C., Böttiger, B. W., Cariou, A., Cronberg, T., Friberg, H., Genbrugge, C., Haywood, K. L., Lilja, G., Moulaert, V. R. M., et al. (2021) · Resuscitation · doi:10.1016/j.resuscitation.2021.02.012 · Cited by 751
“ILCOR suggests that wherever possible, adult patients with non-traumatic OHCA cardiac arrest should be cared for in cardiac arrest centres [17].”
BackgroundSelf-citation
Metadata
- Authors
- Yeung, J., Matsuyama, T., Bray, J., Reynolds, J., & Skrifvars, M. B.
- Affiliations
- University of Warwick (GB)
- Kyoto Prefectural University of Medicine (JP)
- Monash University (AU)
- Michigan State University (US)
- University of Helsinki (FI)
- Corresponding author
- Yeung, J.
- Venue
- Resuscitation
- Publisher
- Elsevier BV
- Published
- 2019-04
- Volume
- 137
- Pages
- 102-115
- ISSN
- 0300-9572 (ISSN-L)
- OpenAlex
- W2913395504
- Cited by
- 116
- References
- 71
- Citations by year
- 2026: 8 · 2025: 13 · 2024: 18 · 2023: 9 · 2022: 18 · 2021: 29 · 2020: 13 · 2019: 7
- FWCI
- 4.28
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Resuscitation (publishedVersion)
- Monash University Research Portal (Monash University) (publishedVersion, other-oa)
- PubMed (publishedVersion)
- Warwick Research Archive Portal (University of Warwick) (acceptedVersion)
- Työväentutkimus Vuosikirja (submittedVersion)
- Warwick Research Archive Portal (University of Warwick) (submittedVersion)
- Funders
- American Heart Association
- Topics
- Health Sciences › Medicine › Emergency Medicine › Cardiac Arrest and Resuscitation
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Palliative Care and End-of-Life Issues
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Mechanical Circulatory Support Devices
- Keywords
- out-of-hospital cardiac arrest, post-resuscitation care, neurological outcome, survival to hospital discharge, return of spontaneous circulation
- MeSH terms
- Adult, Cardiac Care Facilities, Humans, Survival Analysis, Cardiopulmonary Resuscitation, Out-of-Hospital Cardiac Arrest
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
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