German Cardiac Arrest Registry: rationale and design of G-CAR

Janine Pöss, Christoph Sinning, Isabelle Schreiner, Christian Apfelbacher, Karl-Philipp Drewitz, Nadine Hösler, Steffen Schneider, Burkert Pieske, Bernd W Böttiger, Sebastian Ewen, Harm Wienbergen, Malte Kelm, Daniel Bock, Tobias Graf, Christoph Adler, Jochen Dutzmann, Wulf Knie, Martin Orban, Uwe Zeymer, Guido Michels, Holger Thiele, G-CAR Investigators, Janine Pöss, Christoph Sinning, Isabelle Schreiner, Christian Apfelbacher, Karl-Philipp Drewitz, Nadine Hösler, Steffen Schneider, Burkert Pieske, Bernd W Böttiger, Sebastian Ewen, Harm Wienbergen, Malte Kelm, Daniel Bock, Tobias Graf, Christoph Adler, Jochen Dutzmann, Wulf Knie, Martin Orban, Uwe Zeymer, Guido Michels, Holger Thiele, G-CAR Investigators

Abstract

Background: In Germany, 70,000-100,000 persons per year suffer from out-of-hospital cardiac arrest (OHCA). Despite medical progress, survival rates with good neurological outcome remain low. For many important clinical issues, no or only insufficient evidence from randomised trials is available. Therefore, a systemic and standardised acquisition of the treatment course and of the outcome of OHCA patients is warranted.

Study design: The German Cardiac Arrest Registry (G-CAR) is an observational, prospective, multicentre registry. It will determine the characteristics, initial treatment strategies, invasive procedures, revascularisation therapies and the use of mechanical circulatory support devices with a focus on extracorporeal cardiopulmonary resuscitation. A special feature is the prospective 12-month follow-up evaluating mortality, neurological outcomes and several patient-reported outcomes in the psychosocial domain (health-related quality of life, cognitive impairment, depression/anxiety, post-traumatic stress disorder and social reintegration). In a pilot phase of 24 months, 15 centres will include approximately 400 consecutive OHCA patients ≥ 18 years. Parallel to and after the pilot phase, scaling up of G-CAR to a national level is envisaged.

Conclusion: G-CAR is the first national registry including a long-term follow-up for adult OHCA patients. Primary aim is a better understanding of the determinants of acute and long-term outcomes with the perspective of an optimised treatment.

Trial registry: NCT05142124. German Cardiac Arrest Registry (G-CAR).

Keywords: Cardiac arrest centre (CAC); Cardiopulmonary resuscitation (CPR); Extracorporeal cardiopulmonary resuscitation (eCPR); Out-of-hospital cardiac arrest (OHCA); Post-resuscitation care; Registry.

Conflict of interest statement

CA has received a speaker honorarium from AstraZeneca, outside of the submitted work. BWB is treasurer of the European Resuscitation Council (ERC), Chairman of the German Resuscitation Council (GRC), Member of the Advanced Life Support (ALS) Task Force of the International Liaison Committee on Resuscitation (ILCOR), Member of the Executive Committee of the German Interdisciplinary Association for Intensive Care and Emergency Medicine (DIVI), Founder of the “Deutsche Stiftung Wiederbelebung”, Federal Medical Advisor of the German Red Cross (DRK), Co-Editor of “Resuscitation”, Editor of the Journal “Notfall + Rettungsmedizin”, Co-Editor of the Brazilian Journal of Anesthesiology. He received fees for lectures from the following companies: Forum für medizinische Fortbildung (FomF), Baxalta Deutschland GmbH, ZOLL Medical Deutschland GmbH, C.R. Bard GmbH, GS Elektromedizinische Geräte G. Stemple GmbH, Novartis Pharma GmbH, Philips GmbH Market DACH, Bioscience Valuation BSV GmbH. JD has received advisory board honoraria from Pfizer and Novo Nordisk, outside the submitted work. SE received speakers or consultant honorarium and/or travel support from Medtronic, Recor, Bayer, Berlin Chemie, Böhringer Ingelheim, Daiichi Sankyo, Novartis, AstraZeneca, Akcea Therapeutics and Bristol-Myers Squibb-Pfizer. MO has received speaker honoraria from AstraZeneca, Abiomed, CytoSorbents, sedana Medical, outside the submitted work. GM is a co-opted member of the board of the German Society of Medical Intensive Care and Emergency Medicine (Deutsche Gesellschaft für Internistische Intensivmedizin und Notfallmedizin, DGIIN), leader of the working group of “Cardiopulmonary Resuscitation” of the German Society for Cardiology (Deutsche Gesellschaft für Kardiologie, DGK) and deputy speaker of the Cluster A of the DGK; he received lecture fees from Orion Pharma, Sedana Medical and Getinge; Editor of the Journal “Intensiv- und Notfallbehandlung”. The conflicts of interest are not related to the present work. JP, CS, HW, CA, MK, and KPD declare that they have no COI.

© 2022. The Author(s).

Figures

Fig. 1
Fig. 1
G-CAR—registry flow chart (OHCA out-of-hospital cardiac arrest, ROSC return of spontaneous circulation)

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