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Age‐dependent effect of targeted temperature management on outcome after cardiac arrest
Author(s) -
Wallmüller Christian,
Spiel Alexander,
Sterz Fritz,
Schober Andreas,
Hubner Pia,
Stratil Peter,
Testori Christoph
Publication year - 2018
Publication title -
european journal of clinical investigation
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.164
H-Index - 107
eISSN - 1365-2362
pISSN - 0014-2972
DOI - 10.1111/eci.13026
Subject(s) - targeted temperature management , medicine , cohort , retrospective cohort study , return of spontaneous circulation , cohort study , pediatrics , surgery , resuscitation , cardiopulmonary resuscitation
Background In elder patients after out‐of‐hospital cardiac arrest, diminished neurologic function as well as reduced neuronal plasticity may cause a low response to targeted temperature management ( TTM ). Therefore, we investigated the association between TTM (32‐34°C) and neurologic outcome in cardiac arrest survivors with respect to age. Material and Methods This retrospective cohort study included patients 18 years of age or older suffering a witnessed out‐of‐hospital cardiac arrest with presumed cardiac cause, which remained comatose after return of spontaneous circulation. Patients were a priori split by age into four groups (<50 years (n = 496); 50‐64 years (n = 714); 65‐74 years (n = 395); >75 years (n = 280)). Subsequently, within these groups, patients receiving TTM were compared to those not treated with TTM . Results Out of 1885 patients, 921 received TTM for 24 hours. TTM was significantly associated with good neurologic outcome in patients <65 years of age whereas showing no effect in elders (65‐74 years: OR : 1.49 (95% CI : 0.90‐2.47); > 75 years: OR 1.44 (95% CI 0.79‐2.34)). Conclusion In our cohort, it seems that TTM might not be able to achieve the same benefit for neurologic outcome in all age groups. Although the results of this study should be interpreted with caution, TTM was associated with improved neurologic outcome only in younger individuals, patients with 65 years of age or older did not benefit from this treatment.