Abstract P145: Survival is Improved in Successfully Resuscitated Cardiac Arrest Victims Post Therapeutic Hypothermia Initiation at a Single Tertiary Care Centre
Introduction: Therapeutic hypothermia (TH) has been shown to improve neurological outcome after being successfully resuscitated from cardiac arrest (CA). Few studies have been done to identify the benefits of TH and compare the differences in survival and patient factors pre and post initiation of TH at a single center. We hypothesize that survival with complete neurologic recovery (CNR) in successfully resuscitated CA patients is significantly better in those receiving TH as compared to those who did not receive TH.
Methods: This is a retrospective case-control evaluation of consecutive eligible patients who were successfully resuscitated from CA. Using the same predefined inclusion and exclusion criterion; we compared patients admitted from January 2005 through January 2007 who did not receive TH with patient thereafter treated with TH. Chi-square and T test were used to compare the two subsets of patients. Multivariate regression analysis was used to determine predictors of CNR using Pittsburgh cerebral performance category (PCPC) of 1 (CNR), 4 (vegetative state), and 5 (death). Independent predictors are reported as adjusted odds ratios (AOR) with 95% confidence intervals (CI).
Results: Of the 85 patients successfully resuscitated with return of spontaneous circulation (ROSC) after CA, 48 received TH. CNR was more frequent in the TH group when compared to the non-TH group (45.8% vs. 5.4%; p=0.0001). 26 patients died (PCPC=5) in the TH group. In contrast, in the non TH group 35 died during the same hospitalization. Patient who received TH were significantly more likely to have CNR (AOR; 14.39 95% CI; 3.6 – 66.7). After adjusting for baseline characteristics, only CNR was statistically significant between the two groups. (AOR; 0.1; 95% CI; 0.02– 0.53).
Conclusions: As in previous studies, TH was found to be associated with increased CNR when compared to similar population that did not undergo TH at a single tertiary care centre.