Department of Health Sciences, University of York, York, YO10 5DD, UK.
Imperial College NHS Healthcare Trust, London, UK,.
Resuscitation. 2018 Aug;129:70-75. doi: 10.1016/j.resuscitation.2018.03.029. Epub 2018 Mar 22.
Cardiac arrest, particularly in children, often has a poor outcome and international guidelines highlight significant gaps in the evidence base for effective resuscitation. Whilst randomised controlled trials for some interventions can be justified, they are not appropriate for many aspects of resuscitation. Therefore, guidelines must use other sources of data such as epidemiological evidence from cardiac arrest registries, to improve the efficacy of resuscitation. The aim of our study was to identify existing national cardiac arrest registries and document key information about the registries, including whether they contain data on paediatric arrests.
Key bibliographic databases were searched for papers about or using data from cardiac arrest registries. Two reviewers independently screened the search results for relevant papers. A list of registers named in the papers was compiled and information obtained from the papers and the websites of registers where possible.
Twenty three active national or large regional cardiac arrest registries were identified. These included five international collaborations and 10 registries that cover a population of at least 10 million people. Twelve registries are based in Europe, five in North America, four in Asia and two in Australasia. The registries vary in their organisation, but the majority (20) defer to the Utstein reporting guidelines for cardiac arrest. Registries covered populations between 0.4 and 174.5 million and contained between 100 and 605,505 records. Sixteen collected data on out-of-hospital arrests only; three in-hospital arrests only; and four included both. For ten registers the number of paediatric arrests was available and ranged from 56 to 3900.
To our knowledge this report contains the most complete list of active national and large regional cardiac arrest registries. Register data support current guidelines on effective resuscitation however, even the largest registries include relatively small numbers, particularly of paediatric events. A less fragmented approach has the potential to improve the utility of registration data for the benefit of patients.
心脏骤停,尤其是儿童,通常预后较差,国际指南强调了复苏有效证据基础的重大差距。虽然一些干预措施的随机对照试验是合理的,但它们并不适合复苏的许多方面。因此,指南必须使用其他来源的数据,如心脏骤停登记处的流行病学证据,以提高复苏的效果。我们的研究旨在确定现有的国家心脏骤停登记处,并记录登记处的关键信息,包括它们是否包含儿科心脏骤停的数据。
对有关心脏骤停登记处的论文或使用其数据的论文进行了主要文献数据库搜索。两名审查员独立筛选了相关论文的搜索结果。编制了一份登记处名单,并尽可能从论文和登记处的网站上获取信息。
确定了 23 个活跃的国家或大型地区性心脏骤停登记处。其中包括五个国际合作和 10 个覆盖至少 1000 万人口的登记处。12 个登记处位于欧洲,5 个位于北美,4 个位于亚洲,2 个位于澳大拉西亚。这些登记处的组织形式各不相同,但大多数(20 个)都采用了心脏骤停的乌斯坦报告指南。登记处涵盖的人群在 0.4 至 17450 万之间,记录数在 100 至 605505 之间。16 个登记处仅收集院外心脏骤停的数据;3 个仅收集院内心脏骤停的数据;4 个同时包括两者。有 10 个登记处提供儿科心脏骤停的数据,数量从 56 到 3900 不等。
据我们所知,这是目前关于活跃的国家和大型地区性心脏骤停登记处的最完整列表。登记处的数据支持当前关于有效复苏的指南,然而,即使是最大的登记处也只包括相对较少的儿科事件。采用不那么分散的方法有可能提高登记数据的效用,造福于患者。