Objective To determine the relationship between post-rewarming control temperature and neurological outcomes in multicenter post cardiac arrest syndrome (PCAS) registry in South Korea.
Methods We retrospectively analyzed the PCAS registry, which prospectively enrolled out-of-hospital cardiac arrest (OHCA) patients with sustained return of spontaneous circulation in the emergency departments of three urban hospitals from December 2013 to April 2021. Patients who received targeted temperature management (TTM) were included. Body temperature was measured at 4-hour intervals during the first 72 hours after the initiation of TTM. The post-rewarming control temperature was defined as the body temperature measured at 72 hours after TTM initiation. The primary outcome was favorable neurological outcomes, defined as cerebral performance category (CPC) 1-2 at 1-year, and secondary outcome was 1-year mortality.
Results Of the 1,591 patients in the registry, 289 were included in the analysis. A favorable neurological outcome occurred in 75 patients (25.9%). Patients with favorable neurological outcomes exhibited higher body temperature at 4 hours and during 48-72 hours of TTM than those with unfavorable neurological outcomes. Body temperature at 72h of TTM was independently associated with 1-year mortality (adjusted odds ratio [aOR], 0.51; 95% confidence interval, 0.37-0.87; p=0.011), but not with 1-year favorable neurological outcomes (aOR, 1.10; 95% CI, 0.77–1.56; p= 0.573).
Conclusion Low body temperature at 72 hours after TTM was independently associated with 1-year mortality.
Jaehoon Oh, Kyoung-Chul Cha, Jong-Hwan Lee, Seungmin Park, Dong-Hyeok Kim, Byung Kook Lee, Jung Soo Park, Woo Jin Jung, Dong Keon Lee, Young Il Roh, Tae Youn Kim, Sung Phil Chung, Young-Min Kim, June Dong Park, Han-Suk Kim, Mi Jin Lee, Sang-Hoon Na, Gyu Chong Cho, Ai-Rhan Ellen Kim, Sung Oh Hwang, on behalf of the Steering Committee of the 2020 Korean Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care
Clin Exp Emerg Med 2021;8(S):S26-S40. Published online May 21, 2021
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