The Systematic Approach for Identification of Cause Among Out-of-hospital Cardiac Arrest Survivors

NCT06012838 | Completed

• 1 other identifier: 202207125RIND
• Study Type: interventional
• Target: 16
• Locations: 1 country
• Sites: 1

Brief Summary

The cause of cardiac arrest mostly determines outcomes of cardiac arrest survivors. Identifying and treating the cause of cardiac arrest constitute a critical part in post-arrest care. However, the pathophysiology of cardiac arrest often encompasses multiple organ systems. Thus, forming accurate diagnosis for each case presents a daunting challenge, especially for unexperienced physicians. This study aims to evaluate whether a standardized protocol would improve the diagnostic proficiency for out-of-hospital cardiac arrest (OHCA) patients. Sixteen Emergency Medicine Residents from National Taiwan University Hospital participated in this study. The cause classification of OHCA (CCCA) protocol was developed by an expert cardiac arrest committee, and a lecture concerning the Utstein's template, the epidemiology of cardiac arrest and the CCCA protocol was addressed. Pre-/post-lecture questionnaires regarding self-assessed diagnostic certainty and knowledge of cardiac arrest were obtained and compared to evaluate participants' learning effectiveness. To validate the efficiency of protocol, medical records of 586 non-traumatic OHCA adults with successful resuscitation and ICU admission were reviewed retrospectively, and the OHCA cause of each patient was identified by the trained residents following CCCA protocol. The primary outcome was the diagnostic consistency between protocolized diagnosis, expert diagnosis and the discharge diagnosis

Conditions

Out-Of-Hospital Cardiac Arrest

Keywords

Non-traumatic Out-Of-Hospital Cardiac Arrest; training program

Outcome Measures

Primary Outcomes (2)

• diagnostic consistency between protocolized diagnosis and the discharge diagnosis

  The diagnosis made by young physicians with protocol defined as protocolized diagnosis. Expert diagnosis was recognized as diagnosis identified by expert physician. The expert physician is an experienced emergency physicians specialized in both emergency and critical care, who has reviewed the medical records without the assistance of the established CCCA protocol. The discharge diagnosis is the major diagnosis related to index cardiac arrest. The Light's kappa was used to evaluate the consistency of OHCA classification.

  3 months

• diagnostic consistency between protocolized diagnosis and the expert diagnosis

  The diagnosis made by young physicians with protocol defined as protocolized diagnosis. Expert diagnosis was recognized as diagnosis identified by expert physician. The expert physician is an experienced emergency physicians specialized in both emergency and critical care, who has reviewed the medical records without the assistance of the established CCCA protocol. The discharge diagnosis is the major diagnosis related to index cardiac arrest. The Light's kappa was used to evaluate the consistency of OHCA classification.

  3 months

Secondary Outcomes (3)

• Portion of sufficient confidence to make proper OHCA cause identification

  2 months

• the accuracy rates on the classification test of OHCA cause before and after the lecture

  baseline, 2 weeks

• diagnostic consistency between participants before and after the lecture

  baseline, 2 weeks

Study Arms (1)

cause classification of OHCA protocol

EXPERIMENTAL

The cause classification of OHCA protocol was developed by an expert cardiac arrest committee. A lecture concerning the Utstein's template, the epidemiology of cardiac arrest and the CCCA protocol was addressed to the participants.

Behavioral: Cause classification of OHCA protocol

Interventions

Cause classification of OHCA protocol BEHAVIORAL

training program with cause classification of OHCA protocol

cause classification of OHCA protocol

Eligibility Criteria

• Sex: all
• Healthy Volunteers: No
• Age Groups: Child (0-17), Adult (18-64), Older Adult (65+)

You may qualify if:

• Residents of National Taiwan University Hospital

You may not qualify if:

• Visiting staffs of National Taiwan University Hospital

Sponsors & Collaborators

• National Taiwan University Hospital: lead

Study Sites (1)

National Taiwan University Hospital

Taipei County, 100, Taiwan

Location

MeSH Terms

Conditions

Out-of-Hospital Cardiac Arrest

Condition Hierarchy (Ancestors)

Heart Arrest; Heart Diseases; Cardiovascular Diseases

Study Officials

• Min-Shan Tsai, MD, PhD

  National Taiwan University Hospital

  PRINCIPAL INVESTIGATOR

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: NA
• Masking: NONE
• Purpose: DIAGNOSTIC
• Intervention Model: SINGLE GROUP
• Sponsor Type: OTHER
• Responsible Party: SPONSOR

Study Record Dates

• First Submitted: August 8, 2023
• First Posted: August 28, 2023
• Study Start: August 10, 2022
• Primary Completion: November 10, 2022
• Study Completion: November 10, 2022
• Last Updated: August 28, 2023

Record last verified: 2023-08

Locations

TW (1)