Open AccessMortality and Neurological Outcomes in Out-of-Hospital Cardiac Arrest Patients With and Without Targeted Temperature Management in a Multiethnic Asian Population
Author(s) -
Wan Jing Tay,
Huihua Li,
Andrew Fu Wah Ho,
ChingHui Sia,
Georgina Gj Kwek,
Sohil Pothiawala,
Nur Shahidah,
Kenneth Tan,
Aaron Wong,
Duu Wen Sewa,
Eric Lim,
Chee Tang Chin,
Marcus Eh Ong
Publication year - 2020
Publication title -
annals, academy of medicine, singapore/annals of the academy of medicine, singapore
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.299
H-Index - 60
ISSN - 0304-4602
DOI - 10.47102/annals-acadmedsg.2019184
Subject(s) - targeted temperature management , medicine , observational study , return of spontaneous circulation , logistic regression , population , retrospective cohort study , emergency medicine , cardiopulmonary resuscitation , resuscitation , environmental health
The use of targeted temperature management (TTM) is increasing althoughadoption is still variable. We describe our 6-year experience and compare the mortalityand neurological outcomes of out-of-hospital cardiac arrest (OHCA) patients with andwithout the use of TTM in a multiethnic Asian population. Materials and Methods: Weperformed a retrospective observational study at a tertiary academic medical centre. OHCA survivors admitted to our hospital between April 2010‒December 2016 were included. Outcomes of interest were 30-day mortality postresuscitation, Cerebral Performance Category (CPC) and Overall Performance Category (OPC) scores. Results: A total of 121 of 261 patients (46.3%) underwent TTM. TTM patients were younger (TTM 60.0 years old vs no TTM 63.7 years old, P = 0.047). There was no difference in the initialarrest rhythm of shockable origin between the 2 groups (P = 0.289). There was suggestion of lower 30-day mortality (TTM 24.3% vs no TTM 31.4%, P = 0.214), higher and good CPC/OPC scores (TTM 19.0% vs no TTM 15.7%, P = 0.514) with TTM although this did not reach statistical significance. On multivariable logistic regression analysis, TTM was not associated with 30-day mortality (P = 0.07). However, older age, initial non-shockable rhythm and increased duration from arrest to return of spontaneous circulation were associated with increased mortality. Malay ethnicity was associated with a poorer CPC/OPC score. Conclusion: Adoption and outcomes of TTM postresuscitation is variable and there is still a need to optimise management of the identified predictors of survival and good neurological outcomes while TTM is being used.Key words: Heart attack, Neurological function, Neuroprotection, Therapeutic hypothermia