Medical center to continue lead role in Resuscitation Outcomes Consortium

By Connie Piloto / August 2010

UT Southwestern will continue to oversee innovative clinical trials to test the early delivery of interventions for serious trauma and cardiac arrest as part of a federally funded consortium aimed at advancing prehospital emergency care.

The National Institutes of Health and other federal and Canadian agencies recently announced that they will fund the $120 million Resuscitation Outcomes Consortium (ROC) for six more years.

Dr. Ahamed Idris, professor of emergency medicine and a pioneer in resuscitation research and cardiopulmonary resuscitation, is the principal investigator for the DallasFort Worth Center for Resuscitation Research.

The researchers include emergency medical services and fire personnel, public safety workers, hospital staff, community health care providers and medical centers in 10 regions across the United States and Canada.

Since 2004 the ROC has enrolled tens of thousands of patients to test prehospital interventions that aim to improve outcomes in severely ill or injured patients before they are transported to a hospital.

In the DallasFort Worth area about 5,000 paramedics and firefighters from 23 cities and their respective EMS agencies, and 31 hospitals, participate in the ROC studies.

One project that the DFW Center for Resuscitation Research has been engaged in since 2005 is monitoring and improving the quality of CPR being given to people who experience cardiac arrest outside the hospital setting.

“We’re very pleased with the impact that ROC has made in our region,” Dr. Idris said. “As a result of this program, survival to hospital discharge for patients with cardiac arrest increased by more than 60 percent in Dallas County in 2009.”

As part of a pilot study, the ROC is also giving estrogen to patients with severe traumatic injury. The study, headed by Dr. Jane Wigginton, assistant professor of emergency medicine, is in line to roll out as a large, multicenter clinical trial involving other study sites.

To date, more than $55 million has been invested in the ROC’s research programs. Over the next six years, an additional $65 million is being committed, with more than $52 million from the National Heart, Lung, and Blood Institute, the lead federal sponsor of the research project.

While prevention and treatments have boosted the chance of survival significantly from cardiovascular disease, survival rates of patients with cardiac arrest remain low – more than 90 percent of people whose hearts suddenly stop beating at home or at work die before reaching the hospital or being discharged. And trauma is the leading cause of death in children and adults younger than 44.

The ROC also has established the world’s largest observational registry of patients with cardiac arrest. The ROC registry houses data on more than 66,000 patients, and a separate registry contains information on more than 13,000 trauma cases.

The ROC also has demonstrated that better CPR, including more compressions during resuscitation efforts, is associated with greater survival to hospital discharge in patients with ventricular fibrillation, a type of potentially fatal and abrupt disorganization of the heart’s rhythm.

In addition to Dallas, the other U.S. resuscitation centers are in Birmingham, Ala; Milwaukee; Portland, Ore.; Seattle and King County, Wash.; Pittsburgh; and San Diego. In Canada, Toronto; Ottawa; and Vancouver, British Columbia, also have resuscitation centers.