engleski

The influence of therapeutic hypothermia on the outcomes of cardiac arrest survivors: a retrospective cohort study

Aim To determine whether therapeutic hypothermia (TH) improves survival and neurological outcomes in out-of- hospital cardiac arrest (OHCA) survivors. Methods This retrospective cohort study enrolled patients treated for OHCA with a return of spontaneous circulation admitted to the Cardiac Intensive Care Unit from October 2000 until March 2019. Data were collected from medical archives. Propensity score matching was used. The prima- ry endpoint was death during hospital stay and secondary endpoint was cerebral performance category (CPC) score at discharge. Results Out of 152 patients included in the study, 58 (38.7%) underwent TH treatment. After matching (which left 70 patients in the analysis), death during hospital stay occurred less often in TH group (28.6% vs 57.1%, P = 0.029), while the difference in CPC score was not significant. Cox proportional hazards model showed the predictors of death during hospital stay to be TH (hazard ratio [HR] 0.29, 95% confidence interval [CI] 0.13-0.68, P=0.004), initial Glasgow Coma Scale score of 3 (HR 7.55, 95% CI 1.44-39.63, P=0.017), and heart failure (HR 2.35, 95% CI 1.02-5.34, P=0.045). TH was not an independent predictor of CPC score. Mann-Whitney U test and linear regression model showed that TH was associated with higher gain in GCS. Conclusion TH was associated with better survival and certain variables suggesting improved neurological out- comes, suggesting that TH is a vital treatment option for comatose OHCA survivors.

Therapeutic hypothermia ; Out-of-hospital cardiac arrest ; Resuscitation

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