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| Cardiac Arrest Registry to Enhance Survival | |
|---|---|
| Name | Cardiac Arrest Registry to Enhance Survival |
| Abbreviation | CARES |
| Formation | 2004 |
| Type | Registry |
| Headquarters | United States |
| Parent organization | Centers for Disease Control and Prevention; Emory University; Agency for Healthcare Research and Quality |
Cardiac Arrest Registry to Enhance Survival is a national clinical registry focused on out-of-hospital cardiac arrest surveillance and quality improvement. Established to track incidence, treatment, and outcomes of sudden cardiac arrest, it supports systematic measurement across emergency medical services and hospitals in the United States. The registry informs clinical guidelines, public health policy, and resuscitation science through standardized data collection and outcome reporting.
The registry aggregates standardized case data from participating Emergency Medical Services, hospitals, and public safety agencies to measure survival rates, bystander interventions, and treatment timelines for out-of-hospital cardiac arrest. It aligns with reporting frameworks used by American Heart Association, National Institutes of Health, World Health Organization, and regional public health authorities to enable benchmarking. Data elements correspond with international consensus statements from organizations such as European Resuscitation Council, International Liaison Committee on Resuscitation, and specialty societies including Society of Critical Care Medicine.
Initiated in the early 2000s through collaboration among academic centers including Emory University, federal partners like the Centers for Disease Control and Prevention, and nonprofit organizations including the American Heart Association. Early pilots involved municipal systems such as New York City and Atlanta, Georgia EMS bureaus and academic collaborators from institutions like Johns Hopkins University and University of Pennsylvania. Funding and methodological refinement drew on programs at Agency for Healthcare Research and Quality and research networks associated with National Heart, Lung, and Blood Institute initiatives. Over time the registry expanded alongside documented improvements in community CPR training endorsed by figures such as AHA CEO Nancy Brown and public campaigns like Hands-Only CPR.
Case ascertainment follows standardized definitions compatible with consensus templates produced by International Liaison Committee on Resuscitation and reporting guidelines similar to those from STROBE and Utstein Style. Participating EMS systems submit deidentified case reports capturing patient demographics, arrest location, initial rhythm, bystander CPR, automated external defibrillator use, advanced life support interventions, and hospital disposition. Data linkage with hospital records, certified registries like Get With The Guidelines–Resuscitation, and state health departments including California Department of Public Health or Georgia Department of Public Health enables longitudinal outcome tracking. Quality assurance methods incorporate audits by academic centers such as Emory University School of Medicine and analytic approaches used in multicenter trials coordinated by Duke University and Massachusetts General Hospital.
Analyses from the registry have documented variations in survival across metropolitan areas such as Seattle, Philadelphia, and Los Angeles and have identified factors associated with improved outcomes including early bystander CPR, dispatcher-assisted CPR, and public access defibrillation linked to programs in Chicago and Boston. Findings informed guideline updates by American Heart Association and policy recommendations from the Centers for Disease Control and Prevention and influenced community interventions in municipalities including Cleveland and San Francisco. Research leveraging the registry contributed to randomized and observational studies at institutions such as Harvard Medical School, Vanderbilt University Medical Center, and University of Michigan examining temperature management, resuscitation techniques, and postarrest care pathways.
Governance involves stewardship by academic partners including Emory University and oversight relationships with federal agencies like Centers for Disease Control and Prevention and funders such as Agency for Healthcare Research and Quality. Operational support has come from collaborations with nonprofit organizations including American Heart Association and philanthropic contributors. Institutional review and data use agreements involve participating hospitals and municipal EMS agencies such as New York City Fire Department and Los Angeles County Fire Department. Financial models combine federal grants from agencies like National Institutes of Health with institutional support from universities and health systems including Mayo Clinic and Cleveland Clinic.
While originating in the United States, the registry’s methodology has parallels with international registries coordinated by European Resuscitation Council, Resuscitation Council UK, and registries in countries like Japan, Australia, and Canada. Domestic participation includes state and local systems spanning metropolitan and rural areas such as King County, Washington, Cook County, Illinois, and Harris County, Texas. Collaborative research partnerships extend to global academic centers including Karolinska Institutet, University of Toronto, and University College London for comparative effectiveness studies.
Critiques include potential selection bias because participation is voluntary and may overrepresent systems with resources similar to Kaiser Permanente or major academic centers such as Johns Hopkins Hospital. Data completeness and variability in EMS documentation practices across agencies like Fire Department of New York and rural county services can limit generalizability. Privacy, data linkage, and consent issues intersect with regulations administered by entities such as U.S. Department of Health and Human Services and state health departments, and methodological limitations reflect heterogeneity noted by investigators at Yale School of Medicine and Stanford University School of Medicine.
Category:Medical registries