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Cardiac Arrest (CA)SPARCNCT07002294

The Effect of SPecialty cAre on Recovery From Cardiac Arrest Trial (the SPARC Trial)

A study testing Transfer to specialty care in people with Cardiac Arrest (CA) and Heart Arrest, run by University of Pittsburgh at 1 site in United States.

Recruiting

Looking for participants now. Contact the study team or a site below to ask about taking part.

Sites and contacts
Official record
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Trial summary

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. Read more about this study

Who is it for?
Ages 18 years and older
What is being tested?
Transfer to specialty care
Could I receive a placebo?
No, everyone receives an active treatment
How many people
1,618 participants
Where
1 siteUnited States
Study dates
11 May 2026to Jan 2032
Phase
Interventional
Are there results?
Not yet: the study is under way

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 18 years and older
  • All sexes
  • No healthy volunteers
  • Adult, Older adult

Who may be able to join

  • 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

Who cannot join

  • 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

Trial locations and contacts

1 site in 1 country. Contact the study team or a site near you to ask about taking part.

Sara DiFiore-Sprouse contact

4128642284

difioresm@upmc.edu

United States1 site, 1 recruiting
  • University of Pittsburgh Department of Emergency Medicine

    Pittsburgh, Pennsylvania, 15213

    Sara DiFiore-Sprouse, 4128642284, difioresm@upmc.edu

    Jonathan Elmer, MD, MS

    Recruiting

Other trials in United States

About this study

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.

Read the detailed description

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.

Being tested
Transfer to specialty care, Usual care
Keywords
cardiac arrest
Medical subject headings
Heart Arrest, Out-of-Hospital Cardiac Arrest

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • Transfer to specialty careOther

    Interfacility transport and treatment at the specialty care hospital

  • Usual careOther

    Hospitalization and treatment at the closest appropriate facility

Study groups in NCT07002294
Study groupRoleWhat they receive
Transfer to specialty careExperimentalParticipants randomized to receive specialty care will undergo immediate interfacility transport to and hospital treatment at the specialty care hospital
Receives: Other: Transfer to specialty care
Usual careActive comparatorParticipants randomized to the usual care arm will be hospitalized at the first hospital or transferred to the closest appropriate hospital
Receives: Other: Usual care

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Modified Rankin Scale

    The Modified Rankin Scale (mRS) is a measure of functional recovery, measured 90 days after cardiac arrest. A Modified Rankin Score (mRS) of 0 corresponds to full functional recovery and a Modified Rankin Score (mRS) of 6 corresponds to death, with progressively worse functional outcomes at higher scores. Intermediate values reflect progressive functional dependence, with higher scores reflecting greater dependence on others.

    Measured: 90 Days post arrest

Secondary outcomes (3)
  1. Survival to ICU Admission

    Measured: 24 hours post arrest

  2. 72 hour survival

    Measured: 72 hours post arrest

  3. mRS at hospital discharge

    Measured: Up to 6 months post arrest

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted3 Jun 2025
  2. Study start11 May 2026
  3. Primary completionJun 2031 (estimated)
  4. Study completionJan 2032 (estimated)

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Interventional
Phase
Phase N/A
Primary purpose
Treatment
Allocation
Randomised
Intervention model
Parallel groups
Masking
None (open label)
Enrolment
1,618 participants (estimated)
IDs, dates and publications
ClinicalTrials.gov ID
NCT07002294
Sponsor's protocol ID
STUDY25050152
Other IDs
R61HL175113
Acronym
SPARC
Status last verified
Aug 2026
First submitted
23 May 2025
Last updated
6 Aug 2026
Results posted
No
Data monitoring committee
Yes
FDA-regulated drug
No
FDA-regulated device
No
Individual data sharing
Yes: Deidentified data may be shared in the future with investigators at other institutions. The local investigators will execute data use agreements with outside investigators and institutions prior to sharing any data. Identifiable data will not be shared.

Publications

  • Michie S, van Stralen MM, West R. The behaviour change wheel: a new method for characterising and designing behaviour change interventions. Implement Sci. 2011 Apr 23;6:42. doi: 10.1186/1748-5908-6-42.

    PubMed 21513547
  • Elmer J, Weisgerber AR, Wallace DJ, Horne E, Stuart SA, Shutterly K, Callaway CW. Between-hospital variability in organ donation after resuscitation from out-of-hospital cardiac arrest. Resuscitation. 2021 Oct;167:372-379. doi: 10.1016/j.resuscitation.2021.07.038. Epub 2021 Aug 4.

    PubMed 34363855
  • Elmer J, Molyneaux BJ, Shutterly K, Stuart SA, Callaway CW, Darby JM, Weisgerber AR. Organ donation after resuscitation from cardiac arrest. Resuscitation. 2019 Dec;145:63-69. doi: 10.1016/j.resuscitation.2019.10.013. Epub 2019 Oct 22.

    PubMed 31654724
  • Imai K, Keele L, Tingley D. A general approach to causal mediation analysis. Psychol Methods. 2010 Dec;15(4):309-34. doi: 10.1037/a0020761.

    PubMed 20954780
  • VanderWeele TJ. A unification of mediation and interaction: a 4-way decomposition. Epidemiology. 2014 Sep;25(5):749-61. doi: 10.1097/EDE.0000000000000121.

    PubMed 25000145
  • VanderWeele TJ. Bias formulas for sensitivity analysis for direct and indirect effects. Epidemiology. 2010 Jul;21(4):540-51. doi: 10.1097/EDE.0b013e3181df191c.

    PubMed 20479643
  • VanderWeele TJ. Commentary: On Causes, Causal Inference, and Potential Outcomes. Int J Epidemiol. 2016 Dec 1;45(6):1809-1816. doi: 10.1093/ije/dyw230. No abstract available.

    PubMed 28130319
  • Baron RM, Kenny DA. The moderator-mediator variable distinction in social psychological research: conceptual, strategic, and statistical considerations. J Pers Soc Psychol. 1986 Dec;51(6):1173-82. doi: 10.1037//0022-3514.51.6.1173.

    PubMed 3806354
  • Kahan BC, Jairath V, Dore CJ, Morris TP. The risks and rewards of covariate adjustment in randomized trials: an assessment of 12 outcomes from 8 studies. Trials. 2014 Apr 23;15:139. doi: 10.1186/1745-6215-15-139.

    PubMed 24755011
  • Elmer J, Coppler PJ, May TL, Hirsch K, Faro J, Solanki P, Brown M, Puyana JS, Rittenberger JC, Callaway CW. Unsupervised learning of early post-arrest brain injury phenotypes. Resuscitation. 2020 Aug;153:154-160. doi: 10.1016/j.resuscitation.2020.05.051. Epub 2020 Jun 9.

    PubMed 32531403
  • Callaway CW, Schmicker R, Kampmeyer M, Powell J, Rea TD, Daya MR, Aufderheide TP, Davis DP, Rittenberger JC, Idris AH, Nichol G; Resuscitation Outcomes Consortium (ROC) Investigators. Receiving hospital characteristics associated with survival after out-of-hospital cardiac arrest. Resuscitation. 2010 May;81(5):524-9. doi: 10.1016/j.resuscitation.2009.12.006. Epub 2010 Jan 13.

    PubMed 20071070
  • Campbell BCV, Mitchell PJ, Churilov L, Yassi N, Kleinig TJ, Dowling RJ, Yan B, Bush SJ, Dewey HM, Thijs V, Scroop R, Simpson M, Brooks M, Asadi H, Wu TY, Shah DG, Wijeratne T, Ang T, Miteff F, Levi CR, Rodrigues E, Zhao H, Salvaris P, Garcia-Esperon C, Bailey P, Rice H, de Villiers L, Brown H, Redmond K, Leggett D, Fink JN, Collecutt W, Wong AA, Muller C, Coulthard A, Mitchell K, Clouston J, Mahady K, Field D, Ma H, Phan TG, Chong W, Chandra RV, Slater LA, Krause M, Harrington TJ, Faulder KC, Steinfort BS, Bladin CF, Sharma G, Desmond PM, Parsons MW, Donnan GA, Davis SM; EXTEND-IA TNK Investigators. Tenecteplase versus Alteplase before Thrombectomy for Ischemic Stroke. N Engl J Med. 2018 Apr 26;378(17):1573-1582. doi: 10.1056/NEJMoa1716405.

    PubMed 29694815
  • Goyal M, Demchuk AM, Menon BK, Eesa M, Rempel JL, Thornton J, Roy D, Jovin TG, Willinsky RA, Sapkota BL, Dowlatshahi D, Frei DF, Kamal NR, Montanera WJ, Poppe AY, Ryckborst KJ, Silver FL, Shuaib A, Tampieri D, Williams D, Bang OY, Baxter BW, Burns PA, Choe H, Heo JH, Holmstedt CA, Jankowitz B, Kelly M, Linares G, Mandzia JL, Shankar J, Sohn SI, Swartz RH, Barber PA, Coutts SB, Smith EE, Morrish WF, Weill A, Subramaniam S, Mitha AP, Wong JH, Lowerison MW, Sajobi TT, Hill MD; ESCAPE Trial Investigators. Randomized assessment of rapid endovascular treatment of ischemic stroke. N Engl J Med. 2015 Mar 12;372(11):1019-30. doi: 10.1056/NEJMoa1414905. Epub 2015 Feb 11.

    PubMed 25671798
  • Berkhemer OA, Fransen PS, Beumer D, van den Berg LA, Lingsma HF, Yoo AJ, Schonewille WJ, Vos JA, Nederkoorn PJ, Wermer MJ, van Walderveen MA, Staals J, Hofmeijer J, van Oostayen JA, Lycklama a Nijeholt GJ, Boiten J, Brouwer PA, Emmer BJ, de Bruijn SF, van Dijk LC, Kappelle LJ, Lo RH, van Dijk EJ, de Vries J, de Kort PL, van Rooij WJ, van den Berg JS, van Hasselt BA, Aerden LA, Dallinga RJ, Visser MC, Bot JC, Vroomen PC, Eshghi O, Schreuder TH, Heijboer RJ, Keizer K, Tielbeek AV, den Hertog HM, Gerrits DG, van den Berg-Vos RM, Karas GB, Steyerberg EW, Flach HZ, Marquering HA, Sprengers ME, Jenniskens SF, Beenen LF, van den Berg R, Koudstaal PJ, van Zwam WH, Roos YB, van der Lugt A, van Oostenbrugge RJ, Majoie CB, Dippel DW; MR CLEAN Investigators. A randomized trial of intraarterial treatment for acute ischemic stroke. N Engl J Med. 2015 Jan 1;372(1):11-20. doi: 10.1056/NEJMoa1411587. Epub 2014 Dec 17.

    PubMed 25517348
  • Peterson B, Harrell FE. Partial Proportional Odds Models for Ordinal Response Variables. Journal of the Royal Statistical Society Series C (Applied Statistics) 1990;39:205-17

Questions about this trial

What is this clinical trial studying?

A study testing Transfer to specialty care in people with Cardiac Arrest (CA) and Heart Arrest, run by University of Pittsburgh at 1 site in United States.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 4 inclusion and 5 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: looking for participants now, as of the sponsor's last update on 6 Aug 2026. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 1 site in United States. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

Are results available for this study?

This study is still under way. Results are not available in the source record yet.

How can a doctor refer a patient or contact the research team?

Contact Sara DiFiore-Sprouse (4128642284, difioresm@upmc.edu), or a site near the patient. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Modified Rankin Scale (time frame: 90 Days post arrest). It is what the study was designed to measure, not a finding.

Where can I read the original study information?

On the ClinicalTrials.gov record for NCT07002294, which also lists 65 linked publications.

Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 6 Aug 2026.

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