Clinical trial NCT05316779: Perioperative Cardiac Arrest and Outcome
Official title: Perioperative Cardiac Arrest: an Observational Mono-centre 8-year Assessment of Outcome
Study type: OBSERVATIONAL
Overall status: COMPLETED
Conditions: Heart Arrest
Anesthesia
Keywords: Cardiac arrest
Perioperative cardiac arrest
Neurological outcome
Quality of Life
In-hospital cardiac arrest
Lead sponsor: Insel Gruppe AG, University Hospital Bern
Sponsor class: OTHER
First posted: 2022-04-07
Enrollment: 240
Sex: ALL
Standard ages: CHILD
ADULT
OLDER_ADULT
Accepts healthy volunteers: no
Observational model: COHORT
Time perspective: RETROSPECTIVE
Sampling method: NON_PROBABILITY_SAMPLE
Study population: The investigators will include all patients of all ages with a perioperative cardiac arrest at Bern University Hospital from 1st January 2015 until 31st December 2021.

Brief summary: With ethical approvement, the investigators want to assess the incidence, circumstances and outcomes of patients with perioperative cardiac arrests over a period of 8 years.

Currently, there is little data and information about a cardiovascular arrests during anesthesia. Little is also known about the health-related quality of life afterwards. In the investigators research project, the investigators want to find out if there are, for example, specific factors that cause cardiovascular arrests and factors that can improve the chances of survival after a cardiovascular arrest. The investigators are also looking for possible factors and measurements that can minimize or even prevent future events during anesthesia.

Detailed description: A perioperative cardiac arrest is a special form of in-hospital cardiac arrest. It was claimed that perioperative cardiac arrests are under-investigated. The spare existing data suggest incidences of perioperative cardiac arrest to be between 0.5 - 3 per 10.000 for adult patients and 2 - 10 per 10.000 for paediatric patients. Data on circumstances, predictors and outcomes of perioperative cardiac arrest are rare, especially for paediatric patients. Some reports suggest that incidence is negatively associated with a country's higher development. As no Swiss data is available on this topic, this retrospective audit aims to bridge the knowledge gap and finally intends to make clinicians aware of potential risks or contributing factors of survival, which might raise safety for all patients undergoing procedures under anaesthesia.

The investigators will include all patients of all ages with a perioperative cardiac arrest at Bern University Hospital from 1st January 2015 until 31st December 2021 (7 year observational period).

Eligibility criteria: Inclusion Criteria is a perioperative cardiac arrest between 1st January 2015 and 31st December 2021 at Bern University Hospital.

A perioperative cardiac arrest is defined as:

* ≥5 chest compressions (direct, mechanical or extracorporeal Cardiopulmonary Resuscitation (CPR))
* and/or defibrillation (unsynchronised direct current (DC) shock for ventricular fibrillation (VF) or pulseless ventricular tachycardia (pVT) either - external or internal defibrillation with manual or Automated External Defibrillation (AED), shocks by implanted cardioverter defibrillators (ICDs) for VF/pVT, precordial thump)
* In a patient having a procedure under the care of an anaesthesia team (nurse or anaesthesiologist) at the Bern University Hospital: General anaesthesia, regional anaesthesia/ analgesia, sedation, local anaesthesia or monitored anaesthesia care
* Regional block performed by anaesthesiologist outside of operating room
* Obstetric analgesia including remifentanil patient-controlled analgesia (PCA).

Exclusion Criteria:

* A perioperative cardiac arrest before 1st January 2015 or after 31st December 2021
* \<5 chest compressions (direct, mechanical or extracorporeal Cardiopulmonary Resuscitation (CPR))
* All in-hospital cardiac arrests, that occur without being under anaesthesia care
* Patients already admitted to a hospital with a cardiac arrest (out-of hospital cardiac arrests)

Primary outcomes:
measure: Return of spontaneous circulation (ROSC)
timeFrame: 60 minutes
Secondary outcomes:
measure: Sustained ROSC
timeFrame: 60 minutes
measure: Survival post-anaesthesia care unit or intensive care unit
timeFrame: 24 hours
measure: Survival to hospital discharge
timeFrame: 4 weeks
measure: SF-12 after hospital discharge
timeFrame: 1 month
measure: CPC after hospital discharge
timeFrame: 1 month
measure: SF-12 3 month after cardiac arrest
timeFrame: 3 months
measure: CPC 3 month after cardiac arrest
timeFrame: 3 months
Other outcomes:
Locations:
city: Bern
country: Switzerland
facility: University Hospital Bern
Study officials:
affiliation: University of Bern
name: Robert Greif, MD, Prof
role: STUDY_DIRECTOR
References: