The Discover In-Hospital Cardiac Arrest (Discover IHCA) Study: An Investigation of Hospital Practices After In-Hospital Cardiac Arrest.

Q4 Medicine Critical care explorations Pub Date : 2024-09-11 eCollection Date: 2024-09-01 DOI:10.1097/CCE.0000000000001149
Luke Andrea, Nathaniel S Herman, Jacob Vine, Katherine M Berg, Saiara Choudhury, Mariana Vaena, Jordan E Nogle, Saleem M Halablab, Aarthi Kaviyarasu, Jonathan Elmer, Gabriel Wardi, Alex K Pearce, Conor Crowley, Micah T Long, J Taylor Herbert, Kipp Shipley, Brittany D Bissell Turpin, Michael J Lanspa, Adam Green, Shekhar A Ghamande, Akram Khan, Siddharth Dugar, Aaron M Joffe, Michael Baram, Cooper March, Nicholas J Johnson, Alexander Reyes, Krassimir Denchev, Michael Loewe, Ari Moskowitz
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Abstract

Importance: In-hospital cardiac arrest (IHCA) is a significant public health burden. Rates of return of spontaneous circulation (ROSC) have been improving, but the best way to care for patients after the initial resuscitation remains poorly understood, and improvements in survival to discharge are stagnant. Existing North American cardiac arrest databases lack comprehensive data on the post-resuscitation period, and we do not know current post-IHCA practice patterns. To address this gap, we developed the Discover In-Hospital Cardiac Arrest (Discover IHCA) study, which will thoroughly evaluate current post-IHCA care practices across a diverse cohort.

Objectives: Our study collects granular data on post-IHCA treatment practices, focusing on temperature control and prognostication, with the objective of describing variation in current post-IHCA practice.

Design, setting, and participants: This is a multicenter, prospectively collected, observational cohort study of patients who have suffered IHCA and have been successfully resuscitated (achieved ROSC). There are 24 enrolling hospital systems (23 in the United States) with 69 individual enrolling hospitals (39 in the United States). We developed a standardized data dictionary, and data collection began in October 2023, with a projected 1000 total enrollments. Discover IHCA is endorsed by the Society of Critical Care Medicine.

Interventions, outcomes, and analysis: The study collects data on patient characteristics including pre-arrest frailty, arrest characteristics, and detailed information on post-arrest practices and outcomes. Data collection on post-IHCA practice was structured around current American Heart Association and European Resuscitation Council guidelines. Among other data elements, the study captures post-arrest temperature control interventions and post-arrest prognostication methods. Analysis will evaluate variations in practice and their association with mortality and neurologic function.

Conclusions: We expect this study, Discover IHCA, to identify variability in practice and outcomes following IHCA, and be a vital resource for future investigations into best-practice for managing patients after IHCA.

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发现院内心脏骤停(Discover IHCA)研究:院内心脏骤停后医院实践调查。
重要性:院内心脏骤停 (IHCA) 是一项重大的公共卫生负担。自发性循环(ROSC)的恢复率一直在提高,但人们对最初复苏后护理患者的最佳方法仍然知之甚少,出院后存活率的提高也停滞不前。现有的北美心脏骤停数据库缺乏复苏后的全面数据,我们也不知道目前的心脏骤停复苏后实践模式。为了填补这一空白,我们开展了 "发现院内心脏骤停"(Discover IHCA)研究,该研究将对不同人群目前的院内心脏骤停后护理实践进行全面评估:我们的研究收集有关院内心脏骤停后处理方法的详细数据,重点是温度控制和预后,目的是描述当前院内心脏骤停后处理方法的差异:这是一项多中心、前瞻性、观察性队列研究,研究对象是发生 IHCA 并成功复苏(达到 ROSC)的患者。共有 24 个医院系统(美国有 23 个)和 69 家单个参与医院(美国有 39 家)。我们开发了标准化的数据字典,数据收集工作于 2023 年 10 月开始,预计总注册人数为 1000 人。发现 IHCA 得到了重症医学会的认可:该研究收集患者特征数据,包括逮捕前的虚弱程度、逮捕特征以及逮捕后做法和结果的详细信息。根据美国心脏协会和欧洲复苏委员会的现行指南,对心肺复苏术后的实践进行了数据收集。除其他数据元素外,该研究还收集了心跳骤停后的体温控制干预措施和心跳骤停后的预后方法。分析将评估实践中的差异及其与死亡率和神经功能的关系:我们希望通过这项研究发现 IHCA 后的实践和结果差异,并为今后研究 IHCA 后患者管理的最佳实践提供重要资源。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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CiteScore
5.70
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审稿时长
8 weeks
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