Abstract 63: Early Predictors of Good Neurologic Outcome From Out of Hospital Cardiac Arrest Treated With Therapeutic Hypothermia.
Objective: To evaluate early predictors of neurological outcome in patients (pts) resuscitated from OOHCA from any initial rhythm treated with TH.
Methods: This is a sub-analysis of a multi-center trial that enrolled unresponsive stable pts resuscitated from witnessed OOHCA of presumed cardiac origin with any initial rhythm. Primary outcome was good neurological score (CPC 1–2) at 6 months. Initial vital signs and lab values were utilized for analysis. PCI, glucose control, Utstein arrest definitions, time to target temperature and time in target range were analyzed utilizing odds ratios (OR), univariate and step-wise multiple logistic regression to determine the strongest predictors of outcome.
Results: 63 pts were evaluated at 6 months. Good outcome was 59% (24/41) with VF and 9%, (2/22) with PEA/asystole. Factors best predicting good outcome at 6 mos by univariate analysis were, in order; VF, arrest to ROSC, pH, HCO3, SBP, age and PCI. Factors that did not predict outcomes were time from arrest to target T(mean 292 mins), duration out of target T range, initial lactate and duration of glucose >140 or <70 mg/dL. Predictors of good CPC by multiple logistic regression were by OR: VF-32,2, arrest to ROSC /min-0.92 and Hx MI 0.12.
Conclusions: In patients who suffer OOHCA and receive therapeutic hypothermia predictors of good outcome are initial rhythm, time from arrest to ROSC and history of MI. Time from arrest to target temperature, duration outside of target temperature and tight glucose control were not predictive of outcome.
- © 2010 by American Heart Association, Inc.