Improving Outcomes from Out of Hospital Cardiac Arrest: The Cardiac Arrest Individual Registry and Outcomes (CAIRO) Programme
A cardiac arrest occurs when the heart stops beating suddenly. It is one of the most extreme medical emergencies. 60,000 people suffer an out of hospital cardiac arrest (OHCA) in the United Kingdom (UK) each year, with resuscitation attempted in less than half, and less than 10% surviving to hospital discharge. Recently available figures also show that there is considerable variation throughout England in both the frequency with which a heartbeat is regained (return of spontaneous circulation; ROSC), and survival. With support from healthcare commissioners, the hospital care of OHCA is becoming centralised in fewer ‘heart attack centres’. Alongside this concentration of services, we plan to implement a programme of research designed to monitor and improve patient care from the initial ambulance response right through to, and beyond, hospital discharge. This is called the ‘Cardiac Arrest Individual Registry and Outcomes (CAIRO) Programme’.
At the centre of this research was a detailed patient registry: the CAIRO database. This allowed us to link data from different sources and to track each cardiac arrest patient from their initial collapse through to hospital discharge. With the patient’s consent, we completed follow-up assessments at subsequent time points. We aimed to establish the CAIRO database in our own ‘heart attack centre’ (University Hospitals Bristol National Health Service (NHS) Foundation Trust; UH Bristol), and then in two neighbouring hospitals (North Bristol NHS Trust and the Royal United Hospital Bath NHS Trust). We hoped to proceed wider implementation across the Southwest region and nationally. We aimed to show that it is feasible to access and link information about patients, by obtaining the data required to address a number of important research questions about patient outcome covering the patient pathway.
A paper for this study is available