Abstract 206: Utilization and Outcome of Therapeutic Hypothermia for Out-of-Hospital Cardiac Arrest
Background: Therapeutic hypothermia (TH) is recommended in international resuscitation guidelines.TH has been incorporated into the American Heart Association practice guidelines and use of TH has steadily increased, but widespread clinical uptake remains low
Hypothesis: Our aim was to examine the frequency of TH use after cardiac arrest in United States.
Methods: We analyzed data from years 2004-2011 from the United States Nationwide Inpatient Sample which is the largest hospitalization database available in United States. Using International Classification of Diseases-9 (ICD-9) codes, we identified cases with cardiac arrest (427.5) who underwent therapeutic hypothermia (99.81). Population estimates were obtained by complex sample analysis used for NIS design.
Results: The utilization of TH in OHCA has significantly increased from 0.06% in 2004 to 6.43 % in 2011. The TH was utilized more in men (53.5%), age group 65-79 years (35.0%), white ( 59.3% ) , private insurance ( 52.8% ) , charlsons comorbidity index >=2 ( 88.2% ) , hospitals located in urban (91.6%) teaching hospitals ( 58.4% ) , hospitals on the West coast ( 28.1% ) , large bed hospitals ( 72.9% ) . The adjusted odds ratio for hospital mortality among patients undergoing TH was 1.6 (95% CI 1.05-2.52, p=0.027). Number of hospitals performing TH has increased from 2004(0.07%) to 2011(6.31%).
Conclusion: TH utilization appears low but implementation is increasing. Case selection and referral biases limit the analysis of the relationship between center TH volume and in hospital mortality.
Author Disclosures: A. Deshmukh: None. A. Patel: None. N. Patel: None. A. Deshmukh: None. N. Patel: None. A. Guha: None. G. Dhaduk: None. S. Pant: None. S. Solanki: None. S. Manvar: None. S. Arora: None. N. Patel: None. V. Panchal: None. B. Thakkar: None. A. Badheka: None. H. Paydak: None. M. Joshi: None.
- © 2014 by American Heart Association, Inc.