{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,12,6]],"date-time":"2025-12-06T05:02:35Z","timestamp":1764997355496,"version":"build-2065373602"},"reference-count":33,"publisher":"Oxford University Press (OUP)","issue":"4_suppl","license":[{"start":{"date-parts":[[2020,11,1]],"date-time":"2020-11-01T00:00:00Z","timestamp":1604188800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/journals\/pages\/open_access\/funder_policies\/chorus\/standard_publication_model"},{"start":{"date-parts":[[2020,11,1]],"date-time":"2020-11-01T00:00:00Z","timestamp":1604188800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2020,11,1]]},"abstract":"<jats:sec>\n                  <jats:title>Background:<\/jats:title>\n                  <jats:p>Out-of-hospital cardiac arrest (OHCA) is a major cause of death worldwide. Recent guidelines recommend the centralisation of OHCA services in cardiac arrest centres to improve outcomes. In 2015, two major tertiary cardiac centres in London merged to form a large dedicated tertiary cardiac centre. This study aimed to compare the short-term mortality of patients admitted with an OHCA before-and-after the merger of services had taken place and admission criteria were relaxed, which led to managing OHCA in higher volume.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods:<\/jats:title>\n                  <jats:p>We retrospectively analysed the data of OHCA patients pre- and post-merger. Baseline demographic and medical characteristics were recorded, along with factors relating to the cardiac arrest. The primary endpoint was in-hospital mortality.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results:<\/jats:title>\n                  <jats:p>OHCA patients (N =728; 267 pre- and 461 post-merger) between 2013 and 2018 were analysed. Patients admitted pre-merger were older (65.0 vs. 62.4 years, p=0.027), otherwise there were similar baseline demographic and peri-arrest characteristics. There was a greater proportion of non-acute coronary syndrome-related OHCA admission post-merger (10.1% vs. 23.4%, p=0.0001) and a corresponding decrease in those admitted with ST-elevation myocardial infarction (80.2% vs. 57.0%, p=0.0001) and those treated with percutaneous coronary intervention (78.8% vs. 54.0%, p=0.0001). Despite this, in-hospital mortality was lower post-merger (63.7% vs. 44.3%, p=0.0001), which persisted after adjustment for demographic and arrest-related characteristics using stepwise logistic regression (p=0.036) between the groups.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusion:<\/jats:title>\n                  <jats:p>Despite an increase in non-acute coronary syndrome-related OHCA cases, the formation of a centralised invasive heart centre was associated with improved survival in OHCA patients. This suggests there may be a benefit of a cardiac arrest centre model of care.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1177\/2048872620974606","type":"journal-article","created":{"date-parts":[[2020,11,26]],"date-time":"2020-11-26T10:55:16Z","timestamp":1606388116000},"page":"S67-S73","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":8,"title":["An observational study assessing the impact of a cardiac arrest centre on patient outcomes after out-of-hospital cardiac arrest (OHCA)"],"prefix":"10.1093","volume":"9","author":[{"given":"Matthew","family":"Kelham","sequence":"first","affiliation":[{"name":"Barts Interventional Group, Barts Heart Centre, London, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Timothy N","family":"Jones","sequence":"additional","affiliation":[{"name":"Barts Interventional Group, Barts Heart Centre, London, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Krishnaraj S","family":"Rathod","sequence":"additional","affiliation":[{"name":"Barts Interventional Group, Barts Heart Centre, London, UK"},{"name":"Centre for Cardiovascular Medicine and Devices, William Harvey Research Institute, Queen Mary University of London, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Oliver","family":"Guttmann","sequence":"additional","affiliation":[{"name":"Barts Interventional Group, Barts Heart Centre, London, UK"},{"name":"Centre for Cardiovascular Medicine and Devices, William Harvey Research Institute, Queen Mary University of London, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alastair","family":"Proudfoot","sequence":"additional","affiliation":[{"name":"Barts Interventional Group, Barts Heart Centre, London, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Paul","family":"Rees","sequence":"additional","affiliation":[{"name":"Barts Interventional Group, Barts Heart Centre, London, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Charles J","family":"Knight","sequence":"additional","affiliation":[{"name":"Barts Interventional Group, Barts Heart Centre, London, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Muhiddin","family":"Ozkor","sequence":"additional","affiliation":[{"name":"Barts Interventional Group, Barts Heart Centre, London, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Andrew","family":"Wragg","sequence":"additional","affiliation":[{"name":"Barts Interventional Group, Barts Heart Centre, London, UK"},{"name":"Centre for Cardiovascular Medicine and Devices, William Harvey Research Institute, Queen Mary University of London, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ajay","family":"Jain","sequence":"additional","affiliation":[{"name":"Barts Interventional Group, Barts Heart Centre, London, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Andreas","family":"Baumbach","sequence":"additional","affiliation":[{"name":"Barts Interventional Group, Barts Heart Centre, London, UK"},{"name":"Centre for Cardiovascular Medicine and Devices, William Harvey Research Institute, Queen Mary University of London, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Anthony","family":"Mathur","sequence":"additional","affiliation":[{"name":"Barts Interventional Group, Barts Heart Centre, London, UK"},{"name":"Centre for Cardiovascular Medicine and Devices, William Harvey Research Institute, Queen Mary University of London, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Daniel A","family":"Jones","sequence":"additional","affiliation":[{"name":"Barts Interventional Group, Barts Heart Centre, London, UK"},{"name":"Centre for Cardiovascular Medicine and Devices, William Harvey Research Institute, Queen Mary University of London, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[2020,11,1]]},"reference":[{"key":"2021020117045948100_bibr1-2048872620974606","doi-asserted-by":"crossref","first-page":"970","DOI":"10.1016\/S0140-6736(18)30472-0","article-title":"Out-of-hospital cardiac arrest: Current concepts","volume":"391","author":"Myat","year":"2018","journal-title":"Lancet"},{"key":"2021020117045948100_bibr2-2048872620974606","doi-asserted-by":"crossref","first-page":"200","DOI":"10.1161\/CIRCINTERVENTIONS.109.913665","article-title":"Immediate percutaneous coronary intervention is associated with better survival after out-of-hospital cardiac arrest: Insights from the PROCAT (Parisian Region Out of hospital Cardiac ArresT) registry","volume":"3","author":"Dumas","year":"2010","journal-title":"Circ Cardiovasc Interv"},{"key":"2021020117045948100_bibr3-2048872620974606","doi-asserted-by":"crossref","first-page":"63","DOI":"10.1161\/CIRCOUTCOMES.109.889576","article-title":"Predictors of survival from out-of-hospital cardiac arrest: A systematic review and meta-analysis","volume":"3","author":"Sasson","year":"2010","journal-title":"Circ Cardiovasc Qual Outcomes"},{"key":"2021020117045948100_bibr4-2048872620974606","doi-asserted-by":"crossref","first-page":"133","DOI":"10.1016\/j.resuscitation.2016.10.030","article-title":"Epidemiology and outcomes from out-of-hospital cardiac arrests in England","volume":"110","author":"Hawkes","year":"2017","journal-title":"Resuscitation"},{"key":"2021020117045948100_bibr5-2048872620974606","doi-asserted-by":"crossref","first-page":"108","DOI":"10.1016\/j.resuscitation.2015.02.003","article-title":"Out-of-hospital cardiac arrest survival improving over time: Results from the Resuscitation Outcomes Consortium (ROC)","volume":"91","author":"Daya","year":"2015","journal-title":"Resuscitation"},{"key":"2021020117045948100_bibr6-2048872620974606","doi-asserted-by":"crossref","first-page":"1377","DOI":"10.1001\/jama.2013.278483","article-title":"Association of national initiatives to improve cardiac arrest management with rates of bystander intervention and patient survival after out-of-hospital cardiac arrest","volume":"310","author":"Wissenberg","year":"2013","journal-title":"JAMA"},{"key":"2021020117045948100_bibr7-2048872620974606","doi-asserted-by":"crossref","first-page":"247","DOI":"10.1016\/S0300-9572(02)00409-4","article-title":"In-hospital factors associated with improved outcome after out-of-hospital cardiac arrest. A comparison between four regions in Norway","volume":"56","author":"Langhelle","year":"2003","journal-title":"Resuscitation"},{"key":"2021020117045948100_bibr8-2048872620974606","doi-asserted-by":"crossref","first-page":"404","DOI":"10.1016\/j.resuscitation.2006.01.014","article-title":"Major differences in 1-month survival between hospitals in Sweden among initial survivors of out-of-hospital cardiac arrest","volume":"70","author":"Herlitz","year":"2006","journal-title":"Resuscitation"},{"key":"2021020117045948100_bibr9-2048872620974606","doi-asserted-by":"crossref","first-page":"709","DOI":"10.1161\/CIR.0b013e3181cdb7db","article-title":"Regional systems of care for out-of-hospital cardiac arrest: A policy statement from the American Heart Association","volume":"121","author":"Nichol","year":"2010","journal-title":"Circulation"},{"key":"2021020117045948100_bibr10-2048872620974606","doi-asserted-by":"crossref","first-page":"188","DOI":"10.1097\/SLA.0000000000001393","article-title":"The impact of a pan-regional inclusive trauma system on quality of care","volume":"264","author":"Cole","year":"2016","journal-title":"Ann Surg"},{"key":"2021020117045948100_bibr11-2048872620974606","doi-asserted-by":"crossref","first-page":"S465","DOI":"10.1161\/CIR.0000000000000262","article-title":"Part 8: Post-cardiac arrest care: 2015 American Heart Association Guidelines update for cardiopulmonary resuscitation and emergency cardiovascular care","volume":"132","author":"Callaway","year":"2015","journal-title":"Circulation"},{"key":"2021020117045948100_bibr12-2048872620974606","doi-asserted-by":"crossref","first-page":"29","DOI":"10.1016\/j.resuscitation.2006.08.016","article-title":"Implementation of a standardised treatment protocol for post resuscitation care after out-of-hospital cardiac arrest","volume":"73","author":"Sunde","year":"2007","journal-title":"Resuscitation"},{"key":"2021020117045948100_bibr13-2048872620974606","doi-asserted-by":"crossref","first-page":"21","DOI":"10.1016\/j.tacc.2016.05.001","article-title":"Do cardiac arrest centres save more lives?","volume":"7-8","author":"S\u00f8reide","year":"2016","journal-title":"Trends Anaesth Crit Care"},{"key":"2021020117045948100_bibr14-2048872620974606","doi-asserted-by":"crossref","first-page":"268","DOI":"10.1161\/CIRCOUTCOMES.115.001767","article-title":"Prognostic implications of level-of-care at tertiary heart centers compared with other hospitals after resuscitation from out-of-hospital cardiac arrest","volume":"8","author":"S\u00f8holm","year":"2015","journal-title":"Circ Cardiovasc Qual Outcomes"},{"key":"2021020117045948100_bibr15-2048872620974606","doi-asserted-by":"crossref","first-page":"1645","DOI":"10.1093\/eurheartj\/ehx104","article-title":"Distance to invasive heart centre, performance of acute coronary angiography, and angioplasty and associated outcome in out-of-hospital cardiac arrest: A nationwide study","volume":"38","author":"Tranberg","year":"2017","journal-title":"Eur Heart J"},{"key":"2021020117045948100_bibr16-2048872620974606","doi-asserted-by":"crossref","DOI":"10.1161\/CIRCOUTCOMES.118.005349","article-title":"Association between hospital teaching status and outcomes after out-of-hospital cardiac arrest","volume":"12","author":"Czarnecki","year":"2019","journal-title":"Circ Cardiovasc Qual Outcomes"},{"key":"2021020117045948100_bibr17-2048872620974606","doi-asserted-by":"crossref","first-page":"162","DOI":"10.1016\/j.resuscitation.2012.06.029","article-title":"Tertiary centres have improved survival compared to other hospitals in the Copenhagen area after out-of-hospital cardiac arrest","volume":"84","author":"S\u00f8holm","year":"2013","journal-title":"Resuscitation"},{"key":"2021020117045948100_bibr18-2048872620974606","doi-asserted-by":"crossref","DOI":"10.1016\/j.resuscitation.2015.07.046","article-title":"Part 8: Education, implementation, and teams: 2015 international consensus on cardiopulmonary resuscitation and emergency cardiovascular care science with treatment recommendations","volume":"95","author":"Finn","year":"2015","journal-title":"Resuscitation"},{"key":"2021020117045948100_bibr19-2048872620974606","doi-asserted-by":"crossref","first-page":"511","DOI":"10.7326\/0003-4819-137-6-200209170-00012","article-title":"Is volume related to outcome in health care? A systematic review and methodologic critique of the literature","volume":"137","author":"Halm","year":"2002","journal-title":"Ann Intern Med"},{"key":"2021020117045948100_bibr20-2048872620974606","doi-asserted-by":"crossref","first-page":"l1","DOI":"10.1136\/bmj.l1","article-title":"Impact and sustainability of centralising acute stroke services in English metropolitan areas: Retrospective analysis of hospital episode statistics and stroke national audit data","volume":"364","author":"Morris","year":"2019","journal-title":"BMJ"},{"key":"2021020117045948100_bibr21-2048872620974606","doi-asserted-by":"crossref","first-page":"13","DOI":"10.1016\/j.eclinm.2018.07.001","article-title":"Changing the system \u2013 major trauma patients and their outcomes in the NHS (England) 2008\u201317","volume":"2-3","author":"Moran","year":"2018","journal-title":"EClinicalMedicine"},{"key":"2021020117045948100_bibr22-2048872620974606","doi-asserted-by":"crossref","first-page":"30","DOI":"10.1016\/j.resuscitation.2008.09.001","article-title":"Inter-hospital variability in post-cardiac arrest mortality","volume":"80","author":"Carr","year":"2009","journal-title":"Resuscitation"},{"key":"2021020117045948100_bibr23-2048872620974606","doi-asserted-by":"crossref","first-page":"50","DOI":"10.1016\/j.resuscitation.2019.09.032","article-title":"The effects of route of admission to a percutaneous coronary intervention centre among patients with out-of-hospital cardiac arrest","volume":"145","author":"Suh","year":"2019","journal-title":"Resuscitation"},{"key":"2021020117045948100_bibr24-2048872620974606","unstructured":"London Ambulance Service NHS Trust. Cardiac arrest annual report: 2018\/19, https:\/\/www.londonambulance.nhs.uk\/wp-content\/uploads\/2020\/01\/Cardiac-Arrest-Annual-Report-2018-2019.pdf (accessed 9 March 2020)."},{"key":"2021020117045948100_bibr25-2048872620974606","doi-asserted-by":"crossref","first-page":"1985","DOI":"10.1093\/eurheartj\/ehq151","article-title":"The relation between volume and outcome of coronary interventions: A systematic review and meta-analysis","volume":"31","author":"Post","year":"2010","journal-title":"Eur Heart J"},{"key":"2021020117045948100_bibr26-2048872620974606","doi-asserted-by":"crossref","DOI":"10.1161\/JAHA.114.001462","article-title":"Effect of cardiogenic shock hospital volume on mortality in patients with cardiogenic shock","volume":"4","author":"Shaefi","year":"2015","journal-title":"J Am Heart Assoc"},{"key":"2021020117045948100_bibr27-2048872620974606","doi-asserted-by":"crossref","DOI":"10.1161\/CIR.0000000000000525","article-title":"Contemporary management of cardiogenic shock: A scientific statement from the American Heart Association","volume":"136","author":"Van Diepen","year":"2017","journal-title":"Circulation"},{"key":"2021020117045948100_bibr28-2048872620974606","doi-asserted-by":"crossref","first-page":"1629","DOI":"10.1056\/NEJM199706053362302","article-title":"Immediate coronary angiography in survivors of out-of-hospital cardiac arrest","volume":"336","author":"Spaulding","year":"1997","journal-title":"N Engl J Med"},{"issue":"10","key":"2021020117045948100_bibr29-2048872620974606","doi-asserted-by":"crossref","DOI":"10.1161\/CIRCINTERVENTIONS.114.002303","article-title":"Immediate percutaneous coronary intervention is associated with improved short- and long-term survival after out-of-hospital cardiac arrest","volume":"8","author":"Geri","year":"2015","journal-title":"Circ Cardiovasc Interv"},{"key":"2021020117045948100_bibr30-2048872620974606","doi-asserted-by":"crossref","first-page":"119","DOI":"10.1093\/eurheartj\/ehx393","article-title":"2017 ESC Guidelines for the management of acute myocardial infarction in patients presenting with ST-segment elevation: The Task Force for the management of acute myocardial infarction in patients presenting with ST-segment elevation of the European Society of Cardiology (ESC)","volume":"39","author":"Ibanez","year":"2018","journal-title":"Eur Heart J"},{"key":"2021020117045948100_bibr31-2048872620974606","doi-asserted-by":"crossref","first-page":"31","DOI":"10.4244\/EIJV10I1A7","article-title":"Invasive coronary treatment strategies for out-of-hospital cardiac arrest: A consensus statement from the European Association for Percutaneous Cardiovascular Interventions (EAPCI)\/Stent for Life (SFL) groups","volume":"10","author":"Noc","year":"2014","journal-title":"EuroIntervention"},{"key":"2021020117045948100_bibr32-2048872620974606","doi-asserted-by":"crossref","first-page":"1397","DOI":"10.1056\/NEJMoa1816897","article-title":"Coronary angiography after cardiac arrest without ST-segment elevation","volume":"380","author":"Lemkes","year":"2019","journal-title":"N Engl J Med"},{"key":"2021020117045948100_bibr33-2048872620974606","doi-asserted-by":"crossref","first-page":"92","DOI":"10.1016\/j.ahj.2018.06.016","article-title":"Rationale and design of: A Randomized tRial of Expedited transfer to a cardiac arrest center for non-ST elevation out-of-hospital cardiac arrest: The ARREST randomized controlled trial","volume":"204","author":"Patterson","year":"2018","journal-title":"Am Heart J"}],"container-title":["European Heart Journal. Acute Cardiovascular Care"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/2048872620974606","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"http:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/2048872620974606","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"http:\/\/academic.oup.com\/ehjacc\/article-pdf\/9\/4_suppl\/S67\/36165690\/ehjacc0s67.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"http:\/\/academic.oup.com\/ehjacc\/article-pdf\/9\/4_suppl\/S67\/36165690\/ehjacc0s67.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2021,4,20]],"date-time":"2021-04-20T00:20:20Z","timestamp":1618878020000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/ehjacc\/article\/9\/4_suppl\/S67-S73\/6125557"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,11,1]]},"references-count":33,"journal-issue":{"issue":"4_suppl","published-online":{"date-parts":[[2020,11,1]]},"published-print":{"date-parts":[[2020,11,1]]}},"URL":"https:\/\/doi.org\/10.1177\/2048872620974606","relation":{},"ISSN":["2048-8734","2048-8726"],"issn-type":[{"type":"electronic","value":"2048-8734"},{"type":"print","value":"2048-8726"}],"subject":[],"published-other":{"date-parts":[[2020,11,1]]},"published":{"date-parts":[[2020,11,1]]}}}