Abstract 18391: The Effect of Targeted Temperature Management on the Neurologic Outcome of In-hospital Cardiac Arrest Survivors
Introduction: Cooling patients that have been resuscitated from out-of-hospital cardiac arrest (OHCA) using targeted temperature management (TTM) is standard of care. However the role of TTM in patients after in-hospital cardiac arrest (IHCA) is presently unclear.
Hypothesis: We evaluated the effect of TTM on neurologic outcome of patients after successful resuscitation from IHCA
Methods: A retrospective analysis was performed on prospectively collected data from 112 consecutive, adult IHCA patients admitted to a tertiary cardiac intensive care unit between January 1, 2004, and June 1, 2013. Patients were categorized into the hypothermia group (underwent TTM) and the control group (did not undergo TTM). Univariable as well as multivariable analyses by binomial logistic regression were performed on the collected data. The primary outcome was defined as neurologic outcome at hospital discharge using the cerebral performance categories (CPC) (Good= CPC 1-2 and Bad= CPC 3-5 respectively).
Results: Of the 112 patients who formed the study cohort, 84 patients formed the hypothermia group and 28 patients formed the control group. The two groups were similar with respect to age, gender, ethnicity, past medical history, smoking, rate of witnessed cardiac arrest, and time to return of spontaneous circulation(P>0.05). On univariable analysis 34(41%) patients in the hypothermia group had good neurologic outcome as compared to 5 (18%) patients in the control group (p=0.03). On multivariable analysis the use of TTM was the only independent predictor of good neurologic outcome (OR=3.79, 95 % CI: 1.18-12.79, P=0.024).(Figure)
Conclusions: The use of TTM in patients resuscitated from IHCA is associated with significantly better neurologic outcome as compared to similar patients who did not undergo TTM. Larger studies are required to corroborate this finding.
Author Disclosures: J. Lundbye: Honoraria; Modest; Zoll Medical. K.N. Sawyer: None. L. Bergman: None. S. Nair: None. A. Fernandez: None.
- © 2015 by American Heart Association, Inc.