Abstract 17758: Incidence and Predictors of Favourable Outcome 6 Months after an Out-of-Hospital Cardiac Arrest Treated with Hypothermia
Background: There is a high mortality rate in patients presenting with an out-of-hospital cardiac arrest (OHCA). Although not fully applied worldwide, Therapeutic Mild Hypothermia (TMH) is indicated to improve outcome for comatose survivors of an OHCA. The objective of our study was to examine the value of TMH under different clinical circumstances and to find predictors of a favourable patient outcome.
Methods: This is a retrospective analysis covering January 2007 to June 2009 in which 150 Comatose patients post-OHCA were recorded. TMH to 32–34°C (endovascular cooling with CoolGard, for 24 hours) was induced in all resuscitated OHCA patients. Patient outcome was recorded at hospital discharge and after 6–12 months using the Pittsburgh Cerebral Performance Categories (CPC). A favourable outcome was defined as CPC score 1 or 2 at 6–12 months.
Results: Survival at hospital discharge and at 6–12 months FUP was 56.7% and 52.7% respectively. A favourable outcome at 6–12 months was present in 96.2% of the patients who survived. Outcome was related to pre-defined variables such as initial heart rhythm, cause of OHCA, characteristics during resuscitation and TMH. The most important differences between the favourable and unfavourable outcome group were: age (59.0yrs vs. 68.2yrs, P<0.0001), initial rhythm VF (100% vs. 73%, P<0.0001), OHCA caused by non-cardiac cause (1.3% vs. 12.2%, P<0.01).
Conclusions: The large majority of OHCA survivors treated with TMH have a favourable neurological outcome. Especially initial heart rhythm is strongly associated with outcome following an OHCA treated with TMH. None of the patients with a Non-VF initial rhythm had a favourable neurological outcome. Therefore initial heart rhythm could contribute to identify patients who benefit most from active induced cooling.
- © 2010 by American Heart Association, Inc.