ReACanROC: Towards the creation of a France–Canada research network for out-of-hospital cardiac arrest

  • Matthieu Heidet
    Correspondence
    Corresponding author at: SAMU 94, HU Henri Mondor, 51 avenue du Maréchal de Lattre de Tassigny, 94010 Créteil Cedex, Canada.
    Affiliations
    Assistance Publique-Hôpitaux de Paris, SAMU 94 et Urgences, HU Henri Mondor, Créteil, France

    Université Paris-Est Créteil (UPEC), EA-4390 (ARCHeS), Créteil, France
    Search for articles by this author
  • Laurie Fraticelli
    Affiliations
    RESCUe-RESUVal, CH Lucien Hussel, Vienne, France

    Université Claude Bernard Lyon 1, EA-4129 (P2S), Lyon, France
    Search for articles by this author
  • Brian Grunau
    Affiliations
    Univeristy of British Columbia, Department of Emergency Medicine, Vancouver, BC, Canada

    St. Paul's Hospital, Vancouver, BC, Canada

    Centre for Health Evaluation and Outcomes Sciences (CHEOS), Vancouver, BC, Canada
    Search for articles by this author
  • Sheldon Cheskes
    Affiliations
    Sunnybrook Center for Prehospital Medicine, Toronto, ON, Canada

    Li Ka Shing Knowledge Institute, St Michaels Hospital, Toronto, ON, Canada
    Search for articles by this author
  • Valentine Baert
    Affiliations
    French National Out-of-Hospital Cardiac Arrest Registry, RéAC, Lille, France

    Université de Lille, CHU Lille, EA2694 – Santé Publique: Epidémiologie et Qualité des Soins, F-59000 Lille, France
    Search for articles by this author
  • Christian Vilhelm
    Affiliations
    French National Out-of-Hospital Cardiac Arrest Registry, RéAC, Lille, France

    Université de Lille, CHU Lille, EA2694 – Santé Publique: Epidémiologie et Qualité des Soins, F-59000 Lille, France
    Search for articles by this author
  • Hervé Hubert
    Affiliations
    French National Out-of-Hospital Cardiac Arrest Registry, RéAC, Lille, France

    Université de Lille, CHU Lille, EA2694 – Santé Publique: Epidémiologie et Qualité des Soins, F-59000 Lille, France
    Search for articles by this author
  • Karim Tazarourte
    Affiliations
    Université Lyon 1, EA-7425 (HESPER), Lyon, France

    Hospices civils de Lyon, Urgences et SAMU 69, GH Edouard Herriot, Lyon, France
    Search for articles by this author
  • Christian Vaillancourt
    Affiliations
    Department of Emergency Medicine, University of Ottawa, ON, Canada

    Ottawa Hospital Research Institute, Ottawa, ON, Canada
    Search for articles by this author
  • John Tallon
    Affiliations
    Univeristy of British Columbia, Department of Emergency Medicine, Vancouver, BC, Canada

    Department of Emergency Medicine, Vancouver General Hospital (VGH), Vancouver, BC, Canada

    British Columbia Emergency Health Services (BCEHS), Vancouver, BC, Canada
    Search for articles by this author
  • Jim Christenson
    Affiliations
    Univeristy of British Columbia, Department of Emergency Medicine, Vancouver, BC, Canada

    St. Paul's Hospital, Vancouver, BC, Canada

    Centre for Health Evaluation and Outcomes Sciences (CHEOS), Vancouver, BC, Canada
    Search for articles by this author
  • Carlos El Khoury
    Affiliations
    RESCUe-RESUVal, CH Lucien Hussel, Vienne, France

    Médipôle, Hôpital mutualiste, Villeurbanne, France

    Université Lyon 1, EA-7425 (HESPER), Lyon, France
    Search for articles by this author
  • on behalf of the Gr-ReAC CanROC investigators

      Abstract

      Aims

      There are large differences between emergency medical systems, which may account for variability in outcomes. We seek to compare prehospital organizations, response modes, patient characteristics and outcomes after out-of-hospital cardiac arrest, between France and Canada, and discuss the need for the first European–North American prehospital research network on out-of-hospital cardiac arrest.

      Methods

      Preliminary comparative description of data drawn from two nation-wide, population-based, Utstein-style prospectively implemented registries for out-of-hospital cardiac arrest in France and Canada (France: RéAC, Canada: CanROC), covering approximately 80 million people, and soon to be participating in an international research network in 2020.

      Results

      Since creation, 103,722 cases were included in France and approximately 99,317 in Canada. Data used in this work were drawn from 2011 to 2016, and comprised around 33,688 adult, non-traumatic, treated cases in Canada, and 55,358 in France, leading to estimated incidence rates of 75.3/100,000 inhabitants in France and 83/100,000 in Canada. In both countries, out-of-hospital cardiac arrest predominantly occurred in male patients, in their late sixties, at home, of presumed cardiac aetiology. Bystander cardiopulmonary resuscitation was provided in half of the cases. First assessed cardiac rhythm was shockable in 16% (France) vs. 22% (Canada). Professional resuscitation was attempted in 82% (France) and 60% (Canada). Prehospital organizations and response modes differed in the constitution of responding teams (France: physician-led advanced life support, Canada: trained paramedics), in response time intervals (call to first professional responders’ arrival at scene 6.5 min (interquartile range IQR [5.2–8.3]) (Canada) vs. 10 min [7–15] (France)), in on-scene interventions, type of referral at hospital (France: systematic bypass of emergency department, tertiary hospital first, Canada: occasional bypass, mainly closest hospital first), and in outcomes (overall survival at hospital discharge in France: 5% vs. Canada: 11%).

      Conclusion

      Despite similarities in some out-of-hospital cardiac arrest Utstein variables, several differences exist between French and Canadian prehospital systems, and ultimately, between outcomes. The creation of the ReACanROC research network will facilitate the conduction of further analyses to better understand predictors of this variability.

      Keywords

      To read this article in full you will need to make a payment
      Subscribe to Resuscitation
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect

      References

        • Sasson C.
        • Rogers M.A.M.
        • Dahl J.
        • Kellermann A.L.
        Predictors of survival from out-of-hospital cardiac arrest: a systematic review and meta-analysis.
        Circ Cardiovasc Qual Outcomes. 2010; 3: 63-81
        • Okubo M.
        • Schmicker R.H.
        • Wallace D.J.
        • et al.
        Variation in survival after out-of-hospital cardiac arrest between emergency medical services agencies.
        JAMA Cardiol. 2018; 3: 989
        • Symons P.
        • Shuster M.
        International EMS systems: Canada.
        Resuscitation. 2004; 63: 119-122
        • Adnet F.
        • Lapostolle F.
        International EMS systems: France.
        Resuscitation. 2004; 63: 7-9
        • Wengenmayer T.
        • Staudacher D.L.
        Need for speed in out-of-hospital cardiac arrest.
        Resuscitation. 2019; (S0300957219305945)
        • Chocron R.
        • Loeb T.
        • Lamhaut L.
        • et al.
        Ambulance density and outcomes after out-of-hospital cardiac arrest: insights from the Paris – sudden death expertise centre registry.
        Circulation. 2018; (Dec 4 (ahead of pub))
        • Grunau B.
        • Kawano T.
        • Dick W.
        • et al.
        Trends in care processes and survival following prehospital resuscitation improvement initiatives for out-of-hospital cardiac arrest in British Columbia, 2006–2016.
        Resuscitation. 2018; 125: 118-125
        • Yasunaga H.
        • Miyata H.
        • Horiguchi H.
        • et al.
        Population density, call-response interval, and survival of out-of-hospital cardiac arrest.
        Int J Health Geogr. 2011; 10: 26
        • Alanazy A.R.M.
        • Wark S.
        • Fraser J.
        • Nagle A.
        Factors impacting patient outcomes associated with use of emergency medical services operating in urban versus rural areas: a systematic review.
        Int J Environ Res Public Health. 2019; 16: 1728
        • Brooks S.C.
        Bystander CPR: location, location, location.
        Resuscitation. 2013; 84: 711-712
        • Drennan I.R.
        • Strum R.P.
        • Byers A.
        • et al.
        Out-of-hospital cardiac arrest in high-rise buildings: delays to patient care and effect on survival.
        Can Med Assoc J. 2016; 188 (Apr 5): 413-419
        • Karch S.B.
        • Graff J.
        • Young S.
        • Ho C.H.
        Response times and outcomes for cardiac arrests in Las Vegas casinos.
        Am J Emerg Med. 1998; 16: 249-253
        • Heidet M.
        • Mermet É.
        • Vaux J.
        • Jérémie R.
        • Audureau É.
        • Marty J.
        Simulated EMS response times until patients located in public train stations: a geospatial model to improve on-foot accessibility.
        Resuscitation. 2018; 131: e3-e5
        • Silverman R.A.
        • Galea S.
        • Blaney S.
        • et al.
        The “vertical response time”: barriers to ambulance response in an urban area.
        Acad Emerg Med Off J Soc Acad Emerg Med. 2007; 14: 772-778
        • Mell H.K.
        • Mumma S.N.
        • Hiestand B.
        • Carr B.G.
        • Holland T.
        • Stopyra J.
        Emergency medical services response times in rural, suburban, and urban areas.
        JAMA Surg. 2017; 152: 983
        • Hsia R.Y.
        • Huang D.
        • Mann N.C.
        • et al.
        A US national study of the association between income and ambulance response time in cardiac arrest.
        JAMA Netw Open. 2018; 1: e185202
        • Fosbøl E.L.
        • Dupre M.E.
        • Strauss B.
        • et al.
        Association of neighborhood characteristics with incidence of out-of-hospital cardiac arrest and rates of bystander-initiated CPR: implications for community-based education intervention.
        Resuscitation. 2014; 85: 1512-1517
        • Castra L.
        • Genin M.
        • Escutnaire J.
        • et al.
        Socioeconomic status and incidence of cardiac arrest: a spatial approach to social and territorial disparities.
        Eur J Emerg Med. 2019; 26: 180-187
        • Griffis H.M.
        • Band R.A.
        • Ruther M.
        • et al.
        Employment and residential characteristics in relation to automated external defibrillator locations.
        Am Heart J. 2016; 172: 185-191
        • DeRuyter N.P.
        • Husain S.
        • Yin L.
        • et al.
        The impact of first responder turnout and curb-to-care intervals on survival from out-of-hospital cardiac arrest.
        Resuscitation. 2017;
        • Ro Y.S.
        • Shin S.D.
        • Song K.J.
        • et al.
        A trend in epidemiology and outcomes of out-of-hospital cardiac arrest by urbanization level: a nationwide observational study from 2006 to 2010 in South Korea.
        Resuscitation. 2013; 84: 547-557
        • Starks M.A.
        • Schmicker R.H.
        • Peterson E.D.
        • et al.
        Association of neighborhood demographics with out-of-hospital cardiac arrest treatment and outcomes: where you live may matter.
        JAMA Cardiol [Internet]. 2017; (Aug 30 [cited 2017 Sep 18]; Available from: http://cardiology.jamanetwork.com/article.aspx?)https://doi.org/10.1001/jamacardio.2017.2671
      1. Observatoires régionaux des urgences – FHP-MCO [Internet] [cited 2019 Nov 18]. Available from: http://www.fhpmco.fr/2016/12/27/observatoires-regionaux-urgences/.

      2. l’Intérieur M de. Les statistiques des services d’incendie 1 et de secours. Édition 2018. [Internet]. http://www.interieur.gouv.fr/Publications/Statistiques/Securite-civile/2017 [cited 2019 Nov 18]. Available from: http://www.interieur.gouv.fr/Publications/Statistiques/Securite-civile/2017.

        • Morrison L.J.
        • Nichol G.
        • Rea T.D.
        • et al.
        Rationale, development and implementation of the resuscitation outcomes consortium epistry—cardiac arrest.
        Resuscitation. 2008; 78: 161-169
        • Hubert H.
        • Tazarourte K.
        • Wiel E.
        • et al.
        Rationale, methodology, implementation, and first results of the French out-of-hospital cardiac arrest registry.
        Prehosp Emerg Care. 2014; 18: 511-519
        • Luc G.
        • Baert V.
        • Escutnaire J.
        • et al.
        Epidemiology of out-of-hospital cardiac arrest: a French national incidence and mid-term survival rate study.
        Anaesth Crit Care Pain Med. 2019; 38: 131-135
        • Dyson K.
        • Brown S.P.
        • May S.
        • et al.
        International variation in survival after out-of-hospital cardiac arrest: a validation study of the Utstein template.
        Resuscitation. 2019; 138: 168-181
        • Schütte S.
        • Acevedo P.N.M.
        • Flahault A.
        Health systems around the world – a comparison of existing health system rankings.
        J Glob Health. 2018; 8: 010407