Abstract 160: Association Between Targeted Temperature Management and Other Postarrest Care
Background: Targeted temperature management (TTM) is one component of post-arrest care that some successfully resuscitated comatose patients receive. It has been suggested that TTM is one of a group of components of a bundle of care that tend to occur together and may influence outcome.
Objectives: To test the hypothesis that patients who receive TTM receive more specialist consultations, more testing, more interventions, and stay in the hospital longer post-arrest.
Methods: We identified 1817 successfully resuscitated comatose patients from 27 hospitals between 2005-2014, 56% of whom received TTM. We then used a propensity score to create matched pairs of patients (one who received TTM, one who did not) based on age, gender, duration of arrest, initial rhythm, year of arrest, and location of arrest. We created 508 pairs (1016 total) and used conditional fixed-effects logistic regression to determine the association between TTM and the outcome of interest between the matched pairs.
Results: Of the 1016 matched patients, the mean age was 65±15 years, 54% were male, 26% had an initial rhythm of asystole, 54% pulseless electrical activity, and 20% VF/VT; 29% survived to hospital discharge, and of those, 74% had a Cerebral Performance Category score of 1-2 at discharge. The patients who were treated with TTM received significantly more of the following post-arrest: neurology consultations, EEGs, head CT scans, cardiology consultations, cardiac catheterization, ECGs, and echocardiography. They were also more likely to be treated at an academic medical center and had longer hospital stays than their matched counterpart who did not receive TTM. Withdrawal of life-sustaining therapy was not significantly associated with TTM treatment (Table 1).
Conclusions: Patients who received TTM also received more post-arrest testing and treatments, lending support to the idea that TTM is associated with a post-arrest bundle of care.
Author Disclosures: A.V. Grossestreuer: Research Grant; Significant; American Heart Association. S.M. Perman: None. D.J. Wiebe: None. B.S. Abella: Research Grant; Significant; NHLBI, Philips, Medtronic, Doris Duke Foundation. Honoraria; Modest; Medivance. Ownership Interest; Modest; Resuscor. Consultant/Advisory Board; Modest; Velomedix, Heartsine. D.F. Gaieski: Research Grant; Significant; Stryker. Honoraria; Modest; Bard, Stryker. Consultant/Advisory Board; Modest; Stryker.
- © 2014 by American Heart Association, Inc.