The Effect of SPecialty cAre on Recovery From Cardiac Arrest Trial (the SPARC Trial)
University of Pittsburgh
Summary
This randomized clinical trial will determine if adult participants who are in the emergency department after being resuscitated from a cardiac arrest outside of the hospital benefit from care delivered at specialized centers. The main question that it will answer is whether transferring participants to a hospital with a specialized cardiac arrest service improves recovery of function after 90 days. Participants will receive all usual medical care, but some participants will be offered transfer to a regional cardiac arrest center and others will be offered care at the closest appropriate hospital. Investigators will interview participants after 90 days to assess their recovery.
Description
Cardiac arrest is a sudden stopping of the heart, which can sometimes be reversed by rapid cardiopulmonary resuscitation (CPR) and emergency medical care. Each year, over 150,000 Americans are admitted to the hospital after receiving CPR. However, many of these patients die in the hospital. There is wide variation in patient outcomes between hospitals. A key knowledge gap about systems of care is whether specific hospital or subsequent interventions or processes of care are associated with better patient outcomes. Specifically, it is unknown if patient outcomes are improved by specialized cent…
Eligibility
- Age range
- 18+ years
- Sex
- All
- Healthy volunteers
- No
Inclusion Criteria: * Out-of-hospital cardiac arrest * Resuscitated from cardiac arrest with palpable pulse in the emergency department * Treated at one of participating hospital emergency departments * Age ≥18 years Exclusion Criteria: * Known prior advanced directives or decision to limit critical care * Known pre-arrest dependent functional status (e.g., living in a skilled nursing facility, hospice or bedbound) * Arrest in the emergency department \>4 hours after arrival * Traumatic etiology of arrest * Known to have opted-out from the SPARC trial
Interventions
- OtherTransfer to specialty care
Interfacility transport and treatment at the specialty care hospital
- OtherUsual care
Hospitalization and treatment at the closest appropriate facility
Location
- University of Pittsburgh Department of Emergency MedicinePittsburgh, Pennsylvania