Post-admission outcomes of participants in the PARAMEDIC trial: A cluster randomised trial of mechanical or manual chest compressions

Research output: Contribution to journalArticlepeer-review

Authors

  • C Ji
  • R Lall
  • T Quinn
  • C Kaye
  • K Haywood
  • J Horton
  • V Gordon
  • C D Deakin
  • H Pocock
  • A Carson
  • M Smyth
  • N Rees
  • K Han
  • S Byers
  • S Brace-McDonnell
  • Simon Gates
  • G D Perkins
  • PARAMEDIC trial Collaborators

Colleges, School and Institutes

External organisations

  • Warwick Clinical Trials Unit, University of Warwick, Coventry
  • Kingston University and St George's University of London Joint Faculty Health, Social Care and Education, London, UK.
  • Surrey Peri-operative Anaesthesia Critical care collaborative Research Group, Faculty of Health and Medical Sciences, University of Surrey, Guildford, UK; South Central Ambulance Service NHS Foundation Trust, Otterbourne, UK; NIHR Southampton Respiratory Biomedical Research Unit, University Hospital Southampton NHS Foundation Trust, Southampton Hampshire.
  • South Central Ambulance Service NHS Foundation Trust, Otterbourne, UK.
  • West Midlands Ambulance Service NHS Foundation Trust, Brierley Hill, UK.
  • Warwick Clinical Trials Unit, University of Warwick, Coventry, UK; West Midlands Ambulance Service NHS Foundation Trust, Brierley Hill, UK.
  • Welsh Ambulance Services NHS Trust, Denbighshire, Wales, UK.
  • North East Ambulance Service NHS Foundation Trust, Newcastle upon Tyne, UK; Royal Victoria Infirmary, Newcastle upon Tyne, UK.
  • Warwick Clinical Trials Unit, University of Warwick, Coventry, UK; Heart of England NHS Foundation Trust, Birmingham, UK. Electronic address: g.d.perkins@warwick.ac.uk.

Abstract

BACKGROUND: The PARAMEDIC cluster randomised trial evaluated the LUCAS mechanical chest compression device, and did not find evidence that use of mechanical chest compression led to an improvement in survival at 30 days. This paper reports patient outcomes from admission to hospital to 12 months after randomisation.

METHODS: Information about hospital length of stay and intensive care management was obtained through linkage with Hospital Episode Statistics and the Intensive Care National Audit and Research Centre. Patients surviving to hospital discharge were approached to complete questionnaires (SF-12v2, EQ-5D, MMSE, HADS and PTSD-CL) at 90days and 12 months. The study is registered with Current Controlled Trials, number ISRCTN08233942.

RESULTS: 377 patients in the LUCAS arm and 658 patients in the manual chest compression were admitted to hospital. Hospital and intensive care length of stay were similar. Long term follow-up assessments were limited by poor response rates (53.7% at 3 months and 55.6% at 12 months). Follow-up rates were lower in those with worse neurological function. Among respondents, long term health related quality of life outcomes and emotional well-being was similar between groups. Cognitive function, measured by MMSE, was marginally lower in the LUCAS arm mean 26.9 (SD 3.7) compared to control mean 28.0 (SD 2.3), adjusted mean difference -1.5 (95% CI -2.6 to -0.4).

CONCLUSION: There were no clinically important differences identified in outcomes at long term follow-up between those allocated to the mechanical chest compression compared to those receiving manual chest compression.

Details

Original languageEnglish
Pages (from-to)82-88
Number of pages7
JournalResuscitation
Volume118
Early online date5 Jul 2017
Publication statusPublished - Sep 2017

Keywords

  • Journal Article