Therapeutic hypothermia is independently associated with favourable outcome after resuscitation from out-of-hospital cardiac arrest: a retrospective, observational cohort study
Benson-Cooper, K.A.
New Zealand Medical Journal 128(1427): 33-37
2015
ISSN/ISBN: 0028-8446 PMID: 26914002 Document Number: 683094
To determine the association between use of therapeutic hypothermia (TH) after resuscitation from out-of-hospital cardiac arrest (OHCA) and neurological outcome. Retrospective observational cohort study in a tertiary university-associated Level III general ICU of 179 ICU patients in three cohorts ('pre' hypothermia: 58 patients, 'post' hypothermia 69 patients, 'recent' 52 patients) admitted between 1 January, 2009, and 15 April, 2011, after resuscitation from OHCA. TH to 33C for 12 hours. Favourable neurological outcome (transferred home) at hospital discharge. The frequency of bystander CPR increased (38/58, 56/69, 47/52, p=0.04), as did the use of TH (0/58, 25/69, 39/52, p<0.00001) and the frequency of favourable neurological outcome between the three cohorts (21/58, 28/69, 32/52, p=0.02). The cohorts were similar in age, gender, shockable rhythm and time to ROSC. In multivariate analysis, favourable neurological outcome was independently associated with younger age (in 5-year intervals, OR 0.78 [0.67-0.90], p=0.001), bystander CPR (OR 4.8 [1.5-15], p=0.007), shockable rhythm (OR 3.5 [1.1-11], p=0.04), time to ROSC (OR 0.90 [0.86-0.94], p<0.0005) and use of TH (OR 2.8 [1.2-6.2], p=0.01). The use of TH in patients admitted to ICU after resuscitation following OHCA was independently associated with favourable neurological outcome.