Abstract 18280: Induced Hypothermia After Out-of-Hospital Cardiac Arrest: Body Habitus and Survival
Introduction: Recent studies have demonstrated an obesity paradox suggesting that overweight and mildly obese patients with cardiovascular disease may have better outcomes when compared with their underweight or normal weight counterparts.
Hypothesis: The present study sought to test the hypothesis that body habitus is associated with survival in the setting of induced hypothermia after out-of-hospital cardiac arrest.
Methods: We evaluated 90 patients (51 men, 39 women, mean age 60) with out-of-hospital cardiac arrest who underwent induced hypothermia using a target esophageal temperature of 33.5 °C with specific reference to the association between body mass index (BMI) and survival to hospital discharge for shockable and non-shockable electrocardiographic (ECG) rhythms. Pearson’s chi-square tests and Mantel-Haenszel statistics were used to control for associated variables and to test outcomes.
Results: 44 patients presented with shockable ECG rhythms (ventricular fibrillation and pulseless ventricular tachycardia) and 29 survived to hospital discharge (OR, 10.77; 95% CI: 3.55, 34.7; P <0.0001), resulting in a 66% overall rate of survival. 46 patients presented with non-shockable ECG rhythms (pulseless electrical activity and asystole) and 7 survived (OR, 10.77; 95% CI: 3.55, 34.7; P 0.000001), resulting in a 15% overall rate of survival. The rates of survival to hospital discharge were significantly different (p=.007) across BMI categories for patients with shockable rhythms. Morbidly obese patients (obese II+) had the lowest survival rate (22%). Patients who were overweight or moderately obese (obese I) had the highest survival rates, 90% and 80%, respectively. These findings persisted after adjusting for confounding variables.
Conclusions: These data are the first to show that rates of survival to hospital discharge differ across BMI categories for patients who undergo induced hypothermia after experiencing out-of-hospital cardiac arrest. Among patients presenting with shockable ECG rhythms, overweight and moderately obese patients had the highest rates of survival. Further studies are needed to confirm the relationship between body habitus and survival in this cohort of patients.
Author Disclosures: P. Atallah: None. O. Niculescu: None. B. Franklin: None.
- © 2014 by American Heart Association, Inc.