Discover In-Hospital Cardiac Arrest (Discover IHCA)

Discover In-Hospital Cardiac Arrest: A Prospective Multicenter Study of Post-In-Hospital Cardiac Arrest Management Practices

The Discover In-Hospital Cardiac Arrest (IHCA) study is a multicenter, prospective observational study aimed at better understanding variations in practice for the post-in-hospital cardiac arrest patient.

Study Overview

• Status: Completed
• Conditions: Cardiac Arrest

Detailed Description

There is considerable debate among experts concerning many components of intra- and post-arrest care. This study aims to increase the evidence base of these components, particularly temperature control, and prognostication in post-in-hospital cardiac arrest patients. In addition to providing insights regarding immediate and long-term post-arrest care, data collected will also be useful in studying variations in cardiopulmonary resuscitation practices.

This project is endorsed by the Society of Critical Care Medicine's (SCCM) Discovery, the Critical Care Research Network.

• Study Type: Observational
• Enrollment (Actual): 1050

Contacts and Locations

Study Locations

• United States
  • New York
    • Bronx, New York, United States, 10467
      • Montefiore Medical Center

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: Adult; Older Adult
• Accepts Healthy Volunteers: Yes

• Sampling Method: Non-Probability Sample

Study Population

All adult index in-hospital cardiac arrests where ROSC is achieved for > 6 hours and the patient is not transitioned to comfort care in the first 6 hours after ROSC.

Description

Inclusion Criteria:

• Adult (≥18 years old) patients
• Patients with a cardiac arrest (a lack of palpable pulse or perfusing cardiac activity) while admitted to the hospital
• Patients admitted to a ward (telemetry or non-telemetry) or an intensive care unit, or are admitted but still in the emergency department waiting for a hospital bed
• Patients who achieved return of spontaneous circulation (ROSC defined as >20 minutes of sustained spontaneous circulation) OR initiated on extracorporeal membrane oxygenation (eCPR) with chest compressions ongoing
• Patients survived for 6 hours after ROSC

Exclusion Criteria:

• Cardiac arrest in non-inpatients (e.g. outpatients, visitors)
• Patients whose cardiopulmonary resuscitation (CPR) starts outside of the hospital
• Non-index arrests (arrests that are not the patient's first arrest during the hospital admission; this also excludes patients who were initially admitted for an out-of-hospital cardiac arrest)
• Patients suffering IHCA in the operating room (OR) or post anesthesia care unit (PACU)
• Patients with cardiac arrest after arriving to an emergency department (ED) but prior to being evaluated and admitted to the hospital
• Cardiac arrests lasting <2 minutes (i.e. chest compressions performed <2 minutes)
• Cardiac arrests where the patient is transitioned to comfort focused care within 6 hours of return of spontaneous circulation (ROSC)

Study Plan

How is the study designed?

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Fever Incidence	The incidence of fever from ROSC until 96 hours after ROSC among patients who remain comatose	Up to 96-hours post cardiac arrest
Multimodal Prognostication	The use of at least two approaches for prognostication prior to withdrawal of care from ROSC until hospital discharge	Up to 60 days post cardiac arrest
Early Withdrawal of Care	The withdrawal of care from ROSC until 72-hour after ROSC	Up to 72-hours post cardiac arrest

Collaborators and Investigators

• Sponsor: Montefiore Medical Center
• Collaborators: Society of Critical Care Medicine
• Investigators: Principal Investigator: Ari Moskowitz, MD, MPH, Montefiore Medical Center

Study record dates

Study Major Dates

• Study Start (Actual): October 16, 2023
• Primary Completion (Actual): May 30, 2024
• Study Completion (Actual): June 30, 2024

Study Registration Dates

• First Submitted: December 20, 2023
• First Submitted That Met QC Criteria: January 11, 2024
• First Posted (Actual): January 16, 2024

Study Record Updates

• Last Update Posted (Estimated): November 14, 2024
• Last Update Submitted That Met QC Criteria: November 12, 2024
• Last Verified: November 1, 2024

More Information

Terms related to this study

• Keywords: In-hospital cardiac arrest; Post-cardiac arrest
• Additional Relevant MeSH Terms: Cardiovascular Diseases; Heart Diseases; Heart Arrest
• Other Study ID Numbers: 2022-14602

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: NO

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No