- Question
- Does expedited transfer to a cardiac arrest centre, compared with standard care, reduce mortality after resuscitated out-of-hospital cardiac arrest without ST elevation?
- Design
- Prospective, multicentre, open-label, parallel, 1:1 randomised superiority trial conducted in London, UK. Randomisation occurred at the scene by ambulance staff; 862 patients were enrolled between 2018 and 2022.
- Population
- Adults aged 18 years or older with return of spontaneous circulation after out-of-hospital cardiac arrest and no ST elevation on the ECG.
- Intervention
- Expedited delivery directly to the cardiac catheter laboratory of one of seven cardiac arrest centres.
- Control
- Standard care: delivery to the geographically closest emergency department among 32 hospitals.
- Primary outcome
- All-cause mortality at 30 days, analysed by intention to treat excluding those with unknown mortality status.
- Results
- Death at 30 days occurred in 258 (63%) of 411 patients in the cardiac arrest centre group and 258 (63%) of 412 in the standard care group (unadjusted risk ratio for survival 1.00; 95% CI 0.90-1.11; p=0.96).
- Safety
- Serious adverse events occurred in 8 (2%) of 414 patients in the cardiac arrest centre group and 3 (1%) of 413 in the standard care group, none judged related to the intervention.
- Conclusion
- In adults without ST elevation, transfer to a cardiac arrest centre after resuscitated community cardiac arrest did not reduce deaths.
- Why it matters
- The trial does not support routine expedited transfer to specialist centres for patients without ST elevation after resuscitated arrest, providing randomised evidence on a question raised by the international resuscitation community.
Card generated automatically with AI from the abstract of the original publication and the trial registry; every figure was checked against those sources. It may contain errors: verify the data at the source before using it for clinical decisions.
Generated on October 18, 2026