The influence of therapeutic hypothermia on the outcomes of cardiac arrest survivors: a retrospective cohort study.

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Abstrakt

Tytuł:: The influence of therapeutic hypothermia on the outcomes of cardiac arrest survivors: a retrospective cohort study.
Autorzy:: Pavlov M; Marin Pavlov, Department of Cardiology, Sestre Milosrdnice University Hospital Center, Vinogradska cesta 29, 10000 Zagreb, Croatia, .
Babić Z
Đuzel A
Crljenko K
Nedić M
Delić Brkljačić D
Źródło:: Croatian medical journal [Croat Med J] 2020 Feb 29; Vol. 61 (1), pp. 40-48.
Typ publikacji:: Journal Article
Język:: English
Imprint Name(s):: Publication: 2001- : Zagreb : Medicinska Naklada
Original Publication: Zagreb : University of Zagreb Medical School, [1992-
MeSH Terms:: Hypothermia, Induced*
Out-of-Hospital Cardiac Arrest/*mortality
Out-of-Hospital Cardiac Arrest/*therapy
Aged ; Cardiopulmonary Resuscitation ; Female ; Humans ; Male ; Middle Aged ; Propensity Score ; Proportional Hazards Models ; Retrospective Studies ; Survival Rate ; Treatment Outcome
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Entry Date(s):: Date Created: 20200303 Date Completed: 20200731 Latest Revision: 20200731
Update Code:: 20240105
PubMed Central ID:: PMC7063549
PMID:: 32118377
: Czasopismo naukowe

Pełny tekst

Aim: To determine whether therapeutic hypothermia (TH) improves survival and neurological outcomes in out-of-hospital cardiac arrest (OHCA) survivors.
Methods: This retrospective cohort study enrolled patients treated for OHCA with a return of spontaneous circulation admitted to the Cardiac Intensive Care Unit from October 2000 until March 2019. Data were collected from medical archives. Propensity score matching was used. The primary endpoint was death during hospital stay and secondary endpoint was cerebral performance category (CPC) score at discharge.
Results: Out of 152 patients included in the study, 58 (38.7%) underwent TH treatment. After matching (which left 70 patients in the analysis), death during hospital stay occurred less often in TH group (28.6% vs 57.1%, P=0.029), while the difference in CPC score was not significant. Cox proportional hazards model showed the predictors of death during hospital stay to be TH (hazard ratio [HR] 0.29, 95% confidence interval [CI] 0.13-0.68, P=0.004), initial Glasgow Coma Scale score of 3 (HR 7.55, 95% CI 1.44-39.63, P=0.017), and heart failure (HR 2.35, 95% CI 1.02-5.34, P=0.045). TH was not an independent predictor of CPC score. Mann-Whitney U test and linear regression model showed that TH was associated with higher gain in GCS.
Conclusion: TH was associated with better survival and certain variables suggesting improved neurological outcomes, suggesting that TH is a vital treatment option for comatose OHCA survivors.

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