Prehospital critical care for out-of-hospital cardiac arrest
Research type
Research Study
Full title
Prehospital critical care for out-of-hospital cardiac arrest: Mechanism, effect on survival, costs and the barriers to high quality research.
IRAS ID
206386
Contact name
Johannes von Vopelius-Feldt
Contact email
Sponsor organisation
University Hospitals Bristol NHS Foundation Trust
Duration of Study in the UK
2 years, 6 months, 14 days
Research summary
Background
A number of ambulance trusts in the UK send prehospital critical care teams (CCTs) to cases of out-of-hospital cardiac arrest (OHCA). CCTs can undertake additional measures to treat OHCA but research does not shown clear benefits from this practice. The aim of this study is to assess the effect of CCT care on survival from OHCA and to understand what interventions are delivered. In addition we will analyse the costs of CCTs and examine barriers to high quality research in this area.Methods
CCTs try to attend many but not all cases of OHCA in their region. This means that there are two groups of patients with OHCA; one, which receives CCT treatment, and one, which receives standard ambulance response care (advanced life support, ALS). We will compare survival to hospital discharge between these two groups using a statistical procedure called ‘propensity score matching’. The data needed for this matching process are routinely recorded by all English ambulance trusts.CCT treatment is actually a collection of treatments, which includes certain drugs, procedures and the ability to transport patients over greater distances. During OHCA treatment, the CCT might use all, none, or some of these critical care skills. We will attempt to find out which individual treatment has the biggest impact on any survival benefit. This can be done through a software-supported data analysis called multiple logistic regression.
Any benefits that CCTs might have will need to be weighed up against the increased costs of CCT care. We will describe the costs of CCTs for OHCA and compare them to the costs of the standard ambulance response.
The ideal research design to evaluate an intervention like CCTs would be a randomised study. We will use focus group discussions with key stakeholders to analyse barriers to such research.
REC name
Yorkshire & The Humber - Sheffield Research Ethics Committee
REC reference
16/YH/0300
Date of REC Opinion
29 Jul 2016
REC opinion
Further Information Favourable Opinion