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Quality management in resuscitation--towards a European cardiac arrest registry (EuReCa)
Authors:Gräsner J T  Herlitz J  Koster R W  Rosell-Ortiz F  Stamatakis L  Bossaert L
Affiliation:a Department of Anesthesiology and Intensive Care Medicine, University Hospital Schleswig-Holstein, Schwanenweg 21, 24105 Kiel, Germany
b Division of Cardiology, Sahlgrenska University Hospital, SE-413 45 Göteborg, Sweden
c afd. Cardiologie, Kamer F3-239, Academisch Medisch Centrum, Meibergdreef 9, 1105 AZ Amsterdam, The Netherlands
d Empresa Pública de Emergencias (Public Utility for Health Emergencies), Sanitarias, Almería, Spain
e Department of Emergency Medicine CHU Tivoli, ULB, La Louvière, Belgium
f University of Antwerp, Faculty of Medicine Universitetisplein 1, B2610 Antwerp, Belgium
Abstract:

Background

Knowledge about the epidemiology of cardiac arrest in Europe is inadequate.

Aim

To describe the first attempt to build up a Common European Registry of out-of-hospital cardiac arrest, called EuReCa.

Methods

After approaching key persons in participating countries of the European Resuscitation Council, five countries or areas within countries (Belgium, Germany, Andalusia, North Holland, Sweden) agreed to participate. A standardized questionnaire including 28 items, that identified various aspects of resuscitation, was developed to explore the nature of the regional/national registries. This comprises inclusion criteria, data sources, and core data, as well as technical details of the structure of the databases.

Results

The participating registers represent a population of 35 million inhabitants in Europe. During 2008, 12,446 cardiac arrests were recorded. The structure as well as the level of complexity varied markedly between the 5 regional/national registries. The incidence of attempted resuscitation ranged between registers from 17 to 53 per 100,000 inhabitants each year whilst the number of patients admitted to hospital alive ranged from 5 to 18 per 100,000 inhabitants each year. Bystander CPR varied 3-fold from 20% to 60%.

Conclusion

Five countries agreed to participate in an attempt to build up a common European Registry for out-of-hospital cardiac arrest. These regional/national registries show a marked difference in terms of structure and complexity. A marked variation was found between countries in the number of reported resuscitation attempts, the number of patients brought to hospital alive, and the proportion that received bystander CPR. At present, we are unable to explain the reason for the variability but our first findings could be a ‘wake-up-call’ for building up a high quality registry that could provide answers to this and other key questions in relation to the management of out-of-hospital cardiac arrest.
Keywords:Resuscitation   Cardiac arrest   Registry   Register   Quality management   ERC
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