Abstract 7: The Impact of Time to Target Temperature on Survival to Hospital Discharge for Patients Undergoing a Comprehensive Postresuscitation Program Following Out-of-Hospital Cardiac Arrest
Objectives: A comprehensive post-resuscitation program (CPRP) of care including therapeutic hypothermia (TH) is recommended by the 2010 AHA guidelines to improve survival from out-of-hospital cardiac arrest (OOH-CA). We sought to determine the influence of time to target temperature (T2T) on survival.
Methods: Adult, non-traumatic, OOH-CA patients surviving to hospital admission and enrolled in our CPRP between January 2008 and January 2011 were included. Structured data including all relevant interval times from OOH-CA to target temperature were collected retrospectively. T2T was measured from ROSC, and TH duration began after reaching target temperature. Data were analyzed using descriptive statistics and logistic regression (significance α = 0.05).
Results: Of 169 patients enrolled, 56 (33%) were female, 103 (61%) were African American, and mean age was 58.1 years (95% CI 55.83, 60.37). Overall, 84 patients (49.7%) survived to hospital discharge. The odds of survival for VF patients were 6.53 times greater than the PEA patients (95% CI 3.28 to 13.01), so separate analyses were performed. For VF, average T2T was 321.4 ± 180.58 minutes (95% CI 285.41, 357.44), and a longer T2T was a significant predictor for survival (P 0.026). For PEA, the average T2T was 321.7 ± 174.24 minutes (95% CI 279.16, 364.16). There was a trend for a longer T2T to be associated with improved survival in the PEA group (P 0.165).
Conclusions: A longer T2T is associated with survival in patients treated with therapeutic hypothermia after OOH-CA. Patients with longer T2T have a longer total hypothermic treatment time, which may be an important and unique variable in the application of CPRP.
- © 2011 by American Heart Association, Inc.