Korean Cardiac Arrest Research Consortium (KoCARC): rationale, development, and implementation

OBJECTIVE: This study aimed to describe the conceptualization, development, and implementation processes of the newly established Korean Cardiac Arrest Resuscitation Consortium (KoCARC) to improve out-of-hospital cardiac arrest (OHCA) outcomes. METHODS: The KoCARC was established in 2014 by recruiting hospitals willing to participate voluntarily. To enhance professionalism in research, seven research committees, the Epidemiology and Preventive Research Committee, Community Resuscitation Research Committee, Emergency Medical System Resuscitation Research Committee, Hospital Resuscitation Research Committee, Hypothermia and Postresuscitation Care Research Committee, Cardiac Care Resuscitation Committee, and Pediatric Resuscitation Research Committee, were organized under a steering committee. The KoCARC registry was developed with variables incorporated in the currently existing regional OHCA registries and Utstein templates and were collected via a web-based electronic database system. The KoCARC study population comprises patients visiting the participating hospitals who had been treated by the emergency medical system for OHCA presumed to have a cardiac etiology. RESULTS: A total of 62 hospitals volunteered to participate in the KoCARC, which captures 33.0% of the study population in Korea. Web-based data collection started in October 2015, and to date (December 2016), there were 3,187 cases compiled in the registry collected from 32 hospitals. CONCLUSION: The KoCARC is a self-funded, voluntary, hospital-based collaborative research network providing high level evidence in the field of OHCA and resuscitation. This paper will serve as a reference for subsequent KoCARC manuscripts and for data elements collected in the study.

Development and Implementation of Emergency Department based Heat related Illness Active Surveillance System: Effect of Heat Index on Daily Emergency Department Visits due to Heat related Illness

PURPOSE: To evaluate the effect of heat wave on emergency department (ED) visits due to heat related illness, we developed an ED based active surveillance system. We want to identify epidemiology of ED visits due to heat related illness and determine the effect of heat index on daily ED visits due to heat related illness. METHODS: We developed an ED based active surveillance system for adults who visited the ED due to heat stroke, heat exhaustion, heat syncope, heat edema, and heat cramp. We collected demographic and clinical variables, risk factors, and heat index by standardized registry on the webpage. We operated the surveillance into 16 emergency departments in Daegu City from June to September 2011. We analyzed epidemiologic variables descriptively and assessed the effect of heat index on the number of daily ED visits by multivariate Poisson regression analysis. RESULTS: During the study period, 34 cases were registered and nine cases were heat stroke. Heat stroke patients were older, and had more unemployment status than those with other heat related illness (p<0.05). More ED visits due to heat related illness were observed during the danger period than during the cool period, classified by heat index severity (Adjusted odds ratio: 1.72, 95% CI: 1.33-2.23). Increasing heat index by one degree caused more ED visits due to heat related illness (Adjusted incident rate ratio: 1.13, 95% CI: 1.07-1.19). CONCLUSION: We developed an ED based active surveillance system and observed more elderly persons and lower educational level in patients with heat stroke. In addition, increase in heat index significantly affected more daily ED visits due to heat related illness.