Timing for Computed Tomography and Post-Resuscitation Care on Short-Term Outcomes in Out-of-Hospital Cardiac Arrest

November 17, 2025 updated by: National Taiwan University Hospital

Impact of Timing for Computed Tomography and Post-Resuscitation Care Sequence on Short-Term Outcomes in Out-of-Hospital Cardiac Arrest

This retrospective multicenter study investigates the association between the timing of computed tomography (CT) scans and short-term outcomes in adult non-traumatic out-of-hospital cardiac arrest (OHCA) patients who achieved return of spontaneous circulation (ROSC). The study includes cases from January 1, 2016, to August 31, 2024, across six branches of National Taiwan University Hospital. Data collected include demographics, Utstein variables, emergency department (ED) interventions and their timing. Primary outcomes are survival to admission, and 1-day, 3-day, and 7-day survival. Secondary outcomes focus on the timing and sequence of CT imaging and other interventions in relation to short-term prognosis and ED length of stay. The study aims to explore whether earlier CT utilization can improve outcomes in the post-resuscitation phase of care.

Study Overview

Status

Not yet recruiting

Conditions

Detailed Description

Out-of-hospital cardiac arrest (OHCA) patients with return of spontaneous circulation (ROSC) would suffer from an inflammatory response in the body due to hypoxia and subsequent reperfusion injury, known as post-cardiac arrest syndrome (PCAS). Prompt interventions were crucial during this phase at the emergency department. Typically , these patients require rapid computed tomography (CT) scans. CT scans of different body parts aid in diagnosing serious infections (e.g., pneumonia, perforated peptic ulcer) and vascular emergencies (e.g., stroke, intracranial hemorrhage, aortic dissection, aneurysm, pulmonary embolism), enabling timely specialist intervention, catheterization, or surgery. Patients with traumatic cardiac arrest also require CT scans to identify the mechanism of fatal injuries and assess the current injury status.

Theoretically, the ED team would prefer to perform CT scans as quickly as possible after resuscitation. However, PCAS can result in unstable vital signs, and transporting unstable patients to the CT room, with limited resuscitation equipment, carries the risk of recurrent cardiac arrest. As a result, the patient's vitals are stabilized at ED before receiving the CT scan. However, delaying the scan also impedes diagnosis and treatment, prolonging the patient's unstable condition and creating a vicious cycle. Currently, there is no consensus or standard regarding the optimal timing for CT scans after resuscitation, with most literature focusing on brain CT scans. Thus, whether the timing and prioritization of CT scans can break this vicious cycle remains an area requiring further research.

This retrospective study is part of a sequential research effort by our team. We plan to include non-traumatic adult OHCA patients from January 2016 to August 2024 (2016/01/01 to 2024/08/31). The patient population will be drawn from NTU Hospital and its affiliated branches (Hsinchu, Biomedical, and Zhudong) and NTU Yunlin Branch (Huwei and Douliu), covering six hospital areas across three hospitals. Study variables include basic demographics, Utstein Style OHCA registry variables, ED interventions and their timing. Primary outcomes include survival to hospital admission, 1-day, 3-day, and 7-day survival rates. Secondary outcomes will examine the timing of CT scans, the sequence of other interventions, and their relationship to short-term survival and ED length of stay.

Study Type

Observational

Enrollment (Estimated)

5000

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Contact

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Ages Eligible for Study

  • Adult
  • Older Adult

Accepts Healthy Volunteers

No

Sampling Method

Non-Probability Sample

Study Population

Patients with OHCA and ROSC

Description

Inclusion Criteria:

  1. Adults aged 20 years or older.
  2. Patients who experienced out-of-hospital cardiac arrest (OHCA), received resuscitative efforts in the emergency department, achieved return of spontaneous circulation (ROSC), and subsequently underwent computed tomography (CT) imaging (regardless of the anatomical region scanned).

Exclusion Criteria:

  1. Patients with cardiac arrest due to traumatic causes (traumatic OHCA).
  2. Patients who were transferred to non-NTUH-affiliated hospitals for post-resuscitation care.
  3. Patients whose prognosis could not be determined from medical records.
  4. Patients with incomplete, missing, or otherwise restricted medical records that limited data accessibility or review.

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

Cohorts and Interventions

Group / Cohort
OHCA with ROSC and receive CT
Patients who experienced out-of-hospital cardiac arrest, received resuscitative efforts in the emergency department, achieved return of spontaneous circulation (ROSC), and subsequently underwent computed tomography (CT) imaging, regardless of the anatomical region scanned.

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Short-term outcomes (1-day, 3-day, and 7-day in-hospital survival)
Time Frame: 24, 72, and 168 hours following hospital admission from ED
Defined as survival at 24, 72, and 168 hours, respectively, following hospital admission.
24, 72, and 168 hours following hospital admission from ED

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Sponsor

National Taiwan University Hospital

Publications and helpful links

The person responsible for entering information about the study voluntarily provides these publications. These may be about anything related to the study.

General Publications

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start (Estimated)

December 31, 2027

Primary Completion (Estimated)

December 31, 2027

Study Completion (Estimated)

December 31, 2027

Study Registration Dates

First Submitted

April 13, 2025

First Submitted That Met QC Criteria

April 13, 2025

First Posted (Actual)

April 20, 2025

Study Record Updates

Last Update Posted (Actual)

November 19, 2025

Last Update Submitted That Met QC Criteria

November 17, 2025

Last Verified

December 1, 2024

More Information

Terms related to this study

Keywords

Additional Relevant MeSH Terms

Other Study ID Numbers

  • 202409129RINC

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

This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.

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