The Effect of SPecialty cAre on Recovery From Cardiac Arrest Trial (the SPARC Trial)
NCT ID: NCT07002294
Last Updated: 2026-02-05
Study Results
Results pending
The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.
Basic Information
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Recruitment Status
NOT_YET_RECRUITING
Clinical Phase
NA
Total Enrollment
1618 participants
Study Classification
INTERVENTIONAL
Study Start Date
2026-06-30
Study Completion Date
2032-01-31
Brief Summary
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This randomized clinical trial will determine if adult participants who are in the emergency department after being resuscitated from a cardiac arrest outside of the hospital benefit from care delivered at specialized centers.
The main question that it will answer is whether transferring participants to a hospital with a specialized cardiac arrest service improves recovery of function after 90 days.
Participants will receive all usual medical care, but some participants will be offered transfer to a regional cardiac arrest center and others will be offered care at the closest appropriate hospital. Investigators will interview participants after 90 days to assess their recovery.
The main question that it will answer is whether transferring participants to a hospital with a specialized cardiac arrest service improves recovery of function after 90 days.
Participants will receive all usual medical care, but some participants will be offered transfer to a regional cardiac arrest center and others will be offered care at the closest appropriate hospital. Investigators will interview participants after 90 days to assess their recovery.
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Detailed Description
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Cardiac arrest is a sudden stopping of the heart, which can sometimes be reversed by rapid cardiopulmonary resuscitation (CPR) and emergency medical care. Each year, over 150,000 Americans are admitted to the hospital after receiving CPR. However, many of these patients die in the hospital. There is wide variation in patient outcomes between hospitals. A key knowledge gap about systems of care is whether specific hospital or subsequent interventions or processes of care are associated with better patient outcomes. Specifically, it is unknown if patient outcomes are improved by specialized centers or by improved implementation of recommended interventions at all hospitals.
Observational data in our region and internationally suggest that out-of-hospital cardiac arrest outcomes are better when patients who survive CPR are hospitalized in specialty care or high-volume centers. It is unclear from these studies what are the minimal capabilities that distinguish specialty care from usual care and which aspects of specialty care are influencing outcomes.
This trial will take advantage of a regional system of care that includes 18 hospitals in southwestern Pennsylvania that treat over 1,000 patients resuscitated from out-of-hospital cardiac arrest annually. This region includes one high-volume specialty center with specific attention to recommended interventions for this patient population, as well as several secondary and tertiary care facilities with variable resources and approaches to patient care. This randomized trial will compare outcomes for patients assigned to care at the specialty center versus other centers and will leverage the heterogeneity of treatment between centers to understand the influence of specific treatments.
Observational data in our region and internationally suggest that out-of-hospital cardiac arrest outcomes are better when patients who survive CPR are hospitalized in specialty care or high-volume centers. It is unclear from these studies what are the minimal capabilities that distinguish specialty care from usual care and which aspects of specialty care are influencing outcomes.
This trial will take advantage of a regional system of care that includes 18 hospitals in southwestern Pennsylvania that treat over 1,000 patients resuscitated from out-of-hospital cardiac arrest annually. This region includes one high-volume specialty center with specific attention to recommended interventions for this patient population, as well as several secondary and tertiary care facilities with variable resources and approaches to patient care. This randomized trial will compare outcomes for patients assigned to care at the specialty center versus other centers and will leverage the heterogeneity of treatment between centers to understand the influence of specific treatments.
Conditions
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Cardiac Arrest (CA)
Heart Arrest
Heart Arrest, Out-Of-Hospital
Study Design
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Allocation Method
RANDOMIZED
Intervention Model
PARALLEL
Primary Study Purpose
TREATMENT
Blinding Strategy
NONE
Study Groups
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Transfer to specialty care
Participants randomized to receive specialty care will undergo immediate interfacility transport to and hospital treatment at the specialty care hospital
Group Type
EXPERIMENTAL
Transfer to specialty care
Intervention Type
OTHER
Interfacility transport and treatment at the specialty care hospital
Usual care
Participants randomized to the usual care arm will be hospitalized at the first hospital or transferred to the closest appropriate hospital
Group Type
ACTIVE_COMPARATOR
Usual care
Intervention Type
OTHER
Hospitalization and treatment at the closest appropriate facility
Interventions
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Transfer to specialty care
Interfacility transport and treatment at the specialty care hospital
Intervention Type
OTHER
Usual care
Hospitalization and treatment at the closest appropriate facility
Intervention Type
OTHER
Eligibility Criteria
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Inclusion Criteria
* Out-of-hospital cardiac arrest
* Resuscitated from cardiac arrest with palpable pulse in the emergency department
* Treated at one of participating hospital emergency departments
* Age ≥18 years
* Resuscitated from cardiac arrest with palpable pulse in the emergency department
* Treated at one of participating hospital emergency departments
* Age ≥18 years
Exclusion Criteria
* Known prior advanced directives or decision to limit critical care
* Known pre-arrest dependent functional status (e.g., living in a skilled nursing facility, hospice or bedbound)
* Arrest in the emergency department \>4 hours after arrival
* Traumatic etiology of arrest
* Known to have opted-out from the SPARC trial
* Known pre-arrest dependent functional status (e.g., living in a skilled nursing facility, hospice or bedbound)
* Arrest in the emergency department \>4 hours after arrival
* Traumatic etiology of arrest
* Known to have opted-out from the SPARC trial
Minimum Eligible Age
18 Years
Eligible Sex
ALL
Accepts Healthy Volunteers
No
Sponsors
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National Heart, Lung, and Blood Institute (NHLBI)
NIH
Sponsor Role
collaborator
University of Pittsburgh
OTHER
Sponsor Role
lead
Responsible Party
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Jonathan Elmer
Associate Professor
Responsibility Role
PRINCIPAL_INVESTIGATOR
Principal Investigators
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Jonathan Elmer, MD, MS
Role: PRINCIPAL_INVESTIGATOR
University of Pittsburgh
Locations
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University of Pittsburgh Department of Emergency Medicine
Pittsburgh, Pennsylvania, United States
Site Status
Countries
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United States
Central Contacts
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Facility Contacts
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References
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Related Links
Access external resources that provide additional context or updates about the study.
https://www.jointcommission.org/standards/r3-report/r3-report-issue-29-resuscitation-standards-for-hospitals/
Resuscitation Standards for Hospitals - R3 Report. The Joint Commission, 2022. (Accessed Nov 10, 2022
Other Identifiers
Review additional registry numbers or institutional identifiers associated with this trial.
STUDY25050152
Identifier Type: -
Identifier Source: org_study_id
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