A national resuscitation registry of out-of-hospital cardiac arrest in Germany-a pilot study.
BACKGROUND
Survival rate after out-of-hospital cardiac arrest (OHCA) has not significantly increased over the last decade. However, survival rate has been used as a quality benchmark for many emergency medical services. A uniform resuscitation registry may be advantageous for quality management of cardiopulmonary resuscitation (CPR). This study was conducted to evaluate the establishment of a national CPR registry in Germany.


METHODS
A prospective cohort study was performed that included 469 patients who experienced OHCA requiring CPR in the metropolitan area of Dortmund, Germany. Cardiac arrest was defined as concomitant appearance of unconsciousness, apnoea or gasping and pulselessness. All data were collected via a secure and confidential paper-based method as the data set 'Preclinical care'.


RESULTS
Quality of data was classified as 'good' in 33.4%, 'moderate' in 48.4%, and 'bad' in 18.2% of the patients, respectively. Sixty-two percent had OHCA in private residences, 24% of the patients had a first monitored rhythm of ventricular fibrillation (VF) or ventricular tachycardia (VT), 35.2% had return of spontaneous circulation (ROSC) on scene, and patients presenting VF/VT as the first monitored rhythm had higher ROSC rates (51.3%) compared to patients with asystole (22.6%).


CONCLUSIONS
The data set 'Preclinical care' proved to be congruent with the Utstein style, provided further information for national and international comparisons, and enabled a detailed analysis. Optimisation of data collection and introduction of strict control mechanisms may further improve data quality.
Gräsner
Jan-Thorsten
JT
Department of Anaesthesiology and Intensive Care Medicine, University Hospital Schleswig-Holstein, Campus Kiel, Schwanenweg 21, 24105 Kiel, Germany. graesner@anaesthesie.uni-kiel.de
Meybohm
Patrick
P
Fischer
Matthias
M
Bein
Berthold
B
Wnent
Jan
J
Franz
Rüdiger
R
Zander
Josef
J
Lemke
Hans
H
Bahr
Jan
J
Jantzen
Tanja
T
Messelken
Martin
M
Dörges
Volker
V
Böttiger
Bernd W
BW
Scholz
Jens
J
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016887:Cardiopulmonary Resuscitation; D002648:Child; D002675:Child, Preschool; D003326:Coronary Circulation; D004632:Emergency Medical Services; D005260:Female; D005858:Germany / Q000453:epidemiology; D006323:Heart Arrest / Q000453:epidemiology* / Q000628:therapy*; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D008875:Middle Aged; D010865:Pilot Projects; D011446:Prospective Studies; D020127:Recovery of Function; D012042:Registries; D017180:Tachycardia, Ventricular / Q000453:epidemiology; D014693:Ventricular Fibrillation / Q000453:epidemiology; D055815:Young Adult