The International Liaison Committee on Resuscitation has called for a randomised trial of delivery to a cardiac arrest centre. We aimed to assess whether expedited delivery to a cardiac arrest centre compared with current standard of care following resuscitated cardiac arrest reduces deaths. ARREST is a prospective, parallel, multicentre, open-label, randomised superiority trial. Patients (aged ≥18 years) with return of spontaneous circulation following out-of-hospital cardiac arrest without ST elevation were randomly assigned (1:1) at the scene of their cardiac arrest by London Ambulance Service staff using a secure online randomisation system to expedited delivery to the cardiac catheter laboratory at one of seven cardiac arrest centres or standard of care with delivery to the geographically closest emergency department at one of 32 hospitals in London, UK. Masking of the ambulance staff who delivered the interventions and those reporting treatment outcomes in hospital was not possible. The primary outcome was all-cause mortality at 30 days, analysed in the intention-to-treat (ITT) population excluding those with unknown mortality status. Safety outcomes were analysed in the ITT population. The trial was prospectively registered with the International Standard Randomised Controlled Trials Registry, 96585404. Between Jan 15, 2018, and Dec 1, 2022, 862 patients were enrolled, of whom 431 (50%) were randomly assigned to a cardiac arrest centre and 431 (50%) to standard care. 20 participants withdrew from the cardiac arrest centre group and 19 from the standard care group, due to lack of consent or unknown mortality status, leaving 411 participants in the cardiac arrest centre group and 412 in the standard care group for the primary analysis. Of 822 participants for whom data were available, 560 (68%) were male and 262 (32%) were female. The primary endpoint of 30-day mortality occurred in 258 (63%) of 411 participants in the cardiac arrest centre group and in 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). Eight (2%) of 414 patients in the cardiac arrest centre group and three (1%) of 413 in the standard care group had serious adverse events, none of which were deemed related to the trial intervention. In adult patients without ST elevation, transfer to a cardiac arrest centre following resuscitated cardiac arrest in the community did not reduce deaths. British Heart Foundation.

中文翻译：

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因非 ST 段抬高院外心脏骤停 (ARREST) 快速转移至心脏骤停中心：一项英国前瞻性、多中心、平行、随机临床试验

国际复苏联络委员会呼吁对送往心脏骤停中心进行随机试验。我们的目的是评估与当前心脏骤停复苏后的护理标准相比，快速运送至心脏骤停中心是否可以减少死亡人数。ARREST 是一项前瞻性、平行、多中心、开放标签、随机优势试验。院外心脏骤停后恢复自主循环但无 ST 抬高的患者（年龄≥18 岁）在心脏骤停现场由伦敦救护车服务人员使用安全的在线随机分配系统进行随机分配（1:1）加急运送至七个心脏骤停中心之一的心导管实验室，或运送至英国伦敦 32 家医院之一的地理位置最近的急诊科。不可能对提供干预措施的救护车工作人员和报告医院治疗结果的人员进行掩盖。主要结局是 30 天的全因死亡率，在意向治疗 (ITT) 人群中进行分析，不包括死亡率状况未知的人群。对 ITT 人群的安全性结果进行了分析。该试验前瞻性地在国际标准随机对照试验注册中心注册，编号为 96585404。2018 年 1 月 15 日至 2022 年 12 月 1 日期间，入组了 862 名患者，其中 431 名（50%）被随机分配到心脏骤停中心，431 名患者被随机分配到心脏骤停中心。 (50%) 接受标准护理。由于缺乏同意或死亡状况未知，20 名参与者退出心脏骤停中心组，19 名参与者退出标准护理组，留下心脏骤停中心组 411 名参与者和标准护理组 412 名参与者进行初步分析。在 822 名可获得数据的参与者中，560 名（68%）为男性，262 名（32%）为女性。30 天死亡率的主要终点发生在心脏骤停中心组 411 名参与者中的 258 名 (63%) 和标准护理组 412 名参与者中的 258 名 (63%)（未调整的生存风险比 1·00，95% CI 0·90–1·11；p=0·96)。心脏骤停中心组 414 名患者中的 8 名患者 (2%) 和标准护理组 413 名患者中的 3 名患者 (1%) 出现严重不良事件，但均不被视为与试验干预相关。对于没有 ST 段抬高的成年患者，在社区进行心脏骤停复苏后转移至心脏骤停中心并不能减少死亡人数。英国心脏基金会。