RESTORE-ZG: Return of Effective Spontaneous Circulation Resuscitation Evaluation Canton of Zug

NCT07750119 | Completed

• 2 other identifiers: RESTORE_ZG2026-01157
• Study Type: observational
• Target: 240
• Locations: 1 country
• Sites: 1

Brief Summary

This study looked at cardiac arrest that happens outside a hospital. Cardiac arrest means the heart suddenly stops pumping blood. When this happens, a person collapses and needs help right away. The study looked at care given by the emergency medical service of the Canton of Zug in Switzerland. The main goal was to learn what makes it more likely that the heart starts to pump blood again on its own. Doctors call this return of spontaneous circulation (ROSC). The researchers also wanted to describe how well the service performed over four years. The researchers did not test any new treatment. They did not contact any people. Instead, they reviewed records that the service already had, from the years 2022 to 2025. All records were coded so that no person could be identified. The study included 240 people who were treated for cardiac arrest. In about 4 out of 10 people (43 out of 100, or 43%), the heart started to pump blood again during care. The researchers checked whether some factors were linked to this result. These factors were: the heart rhythm found at the start of care how quickly the ambulance reached the person whether someone saw the person collapse whether a bystander or an emergency call handler started cardiopulmonary resuscitation (CPR), which is chest compressions and rescue breaths whether a paramedic or a doctor led the care The heart rhythm at the start was the factor most strongly linked to the heart starting again. The result was similar whether a specially trained paramedic or a doctor led the care. The researchers also wanted to know how well these factors can predict whether the heart will start again. They built two simple tools to estimate the chance of this result. One tool uses information known during the emergency call. The other tool uses information known when the ambulance team arrives. They tested how well the tools worked, and they compared the second tool with a tool that already exists. These tools are early versions. They need to be tested on new patients before they can be used in care. The researchers also looked at whether the result differed by place within the service area and whether it changed over the four years. This study cannot show that one factor causes another. It looked back at past records from one service, so the results may not apply to other places. The study did not follow people after they reached the hospital, so it does not report longer term survival. The findings can help the service review its own care and plan future work.

Conditions

Out-Of-Hospital Cardiac Arrest After Initial Successful Resuscitation; Out of Hospital Cardiac Arrest; Out of Hospital Setting; Defibrillation; Resuscitation; Resuscitation Registry

Keywords

Out-of-hospital cardiac arrest; OHCA; Return of spontaneous circulation; ROSC; Cardiopulmonary resuscitation; CPR; Emergency medical services; EMS; Prehospital; Response time; Critical care paramedic; Physician-staffed EMS; Bystander CPR; Dispatcher-assisted CPR; Initial rhythm; Prognostic score; Risk prediction; Utstein; Registry; Switzerland

Outcome Measures

Primary Outcomes (1)

• Return of spontaneous circulation (ROSC) at hospital handover

  Proportion of participants achieving ROSC, operationalised through the National Advisory Committee for Aeronautics (NACA) score as NACA 6 (ROSC achieved, transported with circulation) versus NACA 7 (death at the scene without sustained circulation).

  From the emergency call to the end of prehospital resuscitation on scene (return of spontaneous circulation achieved and hospitalized, or resuscitation terminated on scene), up to approximately 2 hours

Secondary Outcomes (4)

• Response-time threshold associated with ROSC

  From the emergency call to the end of prehospital resuscitation on scene (return of spontaneous circulation achieved and hospitalized, or resuscitation terminated on scene), up to approximately 1 hour

• ROSC rate by attending qualification (critical care paramedic versus emergency physician)

  From the emergency call to the end of prehospital resuscitation on scene (return of spontaneous circulation achieved and hospitalized, or resuscitation terminated on scene), up to approximately 1 hour

• Discrimination of the RESTORE-ZG On-Scene Score

  From the emergency call to the end of prehospital resuscitation on scene (return of spontaneous circulation achieved, or resuscitation terminated on scene), up to approximately 1 hour

• Geographic distribution of ROSC rate and response time

  From the emergency call to the end of prehospital resuscitation on scene (return of spontaneous circulation achieved, or resuscitation terminated on scene), up to approximately 1 hour

Study Arms (1)

Resuscitation-attempted OHCA (RDZ, 2022 to 2025)

All resuscitation-attempted out-of-hospital cardiac arrest (NACA 6 or 7) managed by the emergency medical service of the Canton of Zug (RDZ) between 1 January 2022 and 31 December 2025, of any etiology including traumatic and non-traumatic causes, with critical care paramedic or emergency physician involvement. Cases were identified by full enumeration of the observation period and validated against the internal resuscitation registry.

Other: Prehospital resuscitation care

Interventions

Prehospital resuscitation care OTHER

Standard prehospital resuscitation delivered by the mixed critical care paramedic and physician EMS system. No intervention was assigned by the study; care was observed as delivered.

Resuscitation-attempted OHCA (RDZ, 2022 to 2025)

Eligibility Criteria

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

Study Population

People who had an out-of-hospital cardiac arrest with a resuscitation attempt in the catchment area of the emergency medical service of the Canton of Zug (Rettungsdienst Kanton Zug, RDZ), Switzerland. The service covers the Canton of Zug and adjacent parts of the cantons of Zurich, Lucerne, Aargau and Schwyz and operates a mixed model in which critical care paramedics and emergency physicians both lead resuscitation. Cases were drawn from the internal RDZ resuscitation registry as a full enumeration of all such arrests managed between 1 January 2022 and 31 December 2025 and were linked to dispatch time stamps from the Sanostat data system. Arrests of any etiology, both non-traumatic and traumatic, were included.

You may qualify if:

• Out-of-hospital cardiac arrest with a resuscitation attempt, managed by the emergency medical service of the Canton of Zug during the observation period NACA score of 6 or 7 at the end of the mission
• Emergency physician or critical care paramedic response as part of the mission (own service physician, REGA, Alpine Air Ambulance, or external physician response)
• Any etiology, including traumatic and non-traumatic causes

You may not qualify if:

• Declaration of death without a resuscitation attempt
• Documented dissent to the further use of health-related data for research
• Missions without usable dispatch time stamps
• Technical duplicate mission records

Sponsors & Collaborators

• Felix Brinkmann: lead
• Emergency Medical Service of the Canton of Zug: collaborator

Study Sites (1)

Rettungsdienst des Kantons Zug (Emergency Medical Service of the Canton of Zug

Zug, Canton of Zug, 6300, Switzerland

Location

Related Publications (5)

• Caputo ML, Baldi E, Savastano S, Burkart R, Benvenuti C, Klersy C, Cianella R, Anselmi L, Moccetti T, Mauri R, De Ferrari GM, Auricchio A. Validation of the return of spontaneous circulation after cardiac arrest (RACA) score in two different national territories. Resuscitation. 2019 Jan;134:62-68. doi: 10.1016/j.resuscitation.2018.11.012. Epub 2018 Nov 14.

  PMID: 30447262 BACKGROUND

• Caputo ML, Baldi E, Burkart R, Wilmes A, Cresta R, Benvenuti C, Oezkartal T, Cianella R, Primi R, Currao A, Bendotti S, Compagnoni S, Gentile FR, Anselmi L, Savastano S, Klersy C, Auricchio A. Validation of Utstein-Based score to predict return of spontaneous circulation (UB-ROSC) in patients with out-of-hospital cardiac arrest. Resuscitation. 2024 Apr;197:110113. doi: 10.1016/j.resuscitation.2024.110113. Epub 2024 Jan 12.

  PMID: 38218400 BACKGROUND

• Baldi E, Caputo ML, Savastano S, Burkart R, Klersy C, Benvenuti C, Sgromo V, Palo A, Cianella R, Cacciatore E, Oltrona Visconti L, De Ferrari GM, Auricchio A. An Utstein-based model score to predict survival to hospital admission: The UB-ROSC score. Int J Cardiol. 2020 Jun 1;308:84-89. doi: 10.1016/j.ijcard.2020.01.032. Epub 2020 Jan 15.

  PMID: 31980268 BACKGROUND

• Grasner JT, Wnent J, Herlitz J, Perkins GD, Lefering R, Tjelmeland I, Koster RW, Masterson S, Rossell-Ortiz F, Maurer H, Bottiger BW, Moertl M, Mols P, Alihodzic H, Hadzibegovic I, Ioannides M, Truhlar A, Wissenberg M, Salo A, Escutnaire J, Nikolaou N, Nagy E, Jonsson BS, Wright P, Semeraro F, Clarens C, Beesems S, Cebula G, Correia VH, Cimpoesu D, Raffay V, Trenkler S, Markota A, Stromsoe A, Burkart R, Booth S, Bossaert L. Survival after out-of-hospital cardiac arrest in Europe - Results of the EuReCa TWO study. Resuscitation. 2020 Mar 1;148:218-226. doi: 10.1016/j.resuscitation.2019.12.042. Epub 2020 Feb 3.

  PMID: 32027980 BACKGROUND

• Grasner JT, Bray JE, Nolan JP, Iwami T, Ong MEH, Finn J, McNally B, Nehme Z, Sasson C, Tijssen J, Lim SL, Tjelmeland I, Wnent J, Dicker B, Nishiyama C, Doherty Z, Welsford M, Perkins GD; International Liaison Committee on Resuscitation. Cardiac arrest and cardiopulmonary resuscitation outcome reports: 2024 update of the Utstein Out-of-Hospital Cardiac Arrest Registry template. Resuscitation. 2024 Aug;201:110288. doi: 10.1016/j.resuscitation.2024.110288. Epub 2024 Jul 24.

  PMID: 39045606 BACKGROUND

MeSH Terms

Conditions

Out-of-Hospital Cardiac Arrest

Condition Hierarchy (Ancestors)

Heart Arrest; Heart Diseases; Cardiovascular Diseases

Study Officials

• Felix Brinkmann

  Rettungsdienst des Kantons Zug (Emergency Medical Service of the Canton of Zug)

  PRINCIPAL INVESTIGATOR

Study Design

• Study Type: observational
• Observational Model: COHORT
• Time Perspective: RETROSPECTIVE
• Sponsor Type: OTHER GOV
• Responsible Party: SPONSOR INVESTIGATOR
• PI Title: CCP-C, TP-C, MBA

Study Record Dates

• First Submitted: July 24, 2026
• First Posted: August 6, 2026
• Study Start: January 1, 2022
• Primary Completion: December 31, 2025
• Study Completion: December 31, 2025
• Last Updated: August 6, 2026

Record last verified: 2026-08

Data Sharing

• IPD Sharing: Will not share

Locations

CH (1)