Targeted temperature management is related to improved clinical outcome of out-of-hospital cardiac arrest with non-shockable initial rhythm
김석구, 차원철, 심민섭, 황승연, 황승연, 신태건, 박주현, 윤희, 조익준, 최진호,
소속 상세정보
김석구 ( Kim Seok-Goo )
Sungkyunkwan University School of Medicine Samsung Medical Center Department of Emergency Medicine
차원철 ( Cha Won-Chul )
Sungkyunkwan University School of Medicine Samsung Medical Center Department of Emergency Medicine
심민섭 ( Sim Min-Seob )
Sungkyunkwan University School of Medicine Samsung Medical Center Department of Emergency Medicine
황승연 ( Hwang Sung-Yeon )
Sungkyunkwan University School of Medicine Samsung Medical Center Department of Emergency Medicine
황승연 ( Hwang Sung-Yeon )
Sungkyunkwan University School of Medicine Samsung Medical Center Department of Emergency Medicine
신태건 ( Shin Tae-Gun )
Sungkyunkwan University School of Medicine Samsung Medical Center Department of Emergency Medicine
박주현 ( Park Joo-Hyun )
Sungkyunkwan University School of Medicine Samsung Medical Center Department of Emergency Medicine
윤희 ( Yoon Hee )
Sungkyunkwan University School of Medicine Samsung Medical Center Department of Emergency Medicine
조익준 ( Jo Ik-Joon )
Sungkyunkwan University School of Medicine Samsung Medical Center Department of Emergency Medicine
최진호 ( Choi Jin-Ho )
Sungkyunkwan University School of Medicine Samsung Medical Center Department of Emergency Medicine
KMID : 0385920190300030208
Abstract
Objective: The benefits of targeted temperature management (TTM) for resuscitated out of hospital cardiac arrest (OHCA) with an initial non-shockable rhythm are still unclear. This study examined whether TTM reduces the mortality and improves the neurological outcomes of OHCA with a non-shockable initial rhythm.
Method: This study analyzed the clinical outcome of 401 resuscitated patients with an initial non-shockable rhythm among a total of 1,616 OHCA patients who were registered in Cardiac Arrest Pursuit Trial with Unique Registration and Epidemiologic Surveillance. The impact of TTM was investigated after accounting for the patients’ propensity for TTM. The primary outcome was a 30-day in-hospital course with a neurologically favorable outcome defined by a cerebral performance categories scale ≤2.
Results: TTM was performed in 89 patients (22%) with an initial non-shockable rhythm. Patients who has received TTM had a tendency to be younger, more likely to be female, and more likely to undergo percutaneous coronary intervention. The clinical outcome of the patients in the initial non-shockable rhythm treated by TTM was superior to those without TTM (hazard ratio [HR], 0.36; 95% confidence interval [CI], 0.27-0.46). Further analysis after propensity score matching or inverse probability of treatment weighting (IPTW) showed consistent findings (propensity score matching: HR, 0.32; 95% CI, 0.22-0.45; IPTW: HR, 0.40; 95% CI, 0.31-0.52; P<0.001, all).
Conclusion: In this nationwide OHCA registry, TTM was related to an approximately three-fold better 30-day neurologically favorable survival of resuscitated patients with TTM treatment than patients without TTM in the initial non-shockable rhythm.
키워드
Out-of-hospital cardiac arrest; Induced hypothermia; Cardiopulmonary resuscitation; Prognosis
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