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Croatian Medical Journal, Vol. 61 No. 6, 2020.

Original scientific paper

https://doi.org/10.3325/cmj.2020.61.40

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

Marin Pavlov ; Department of Cardiology, Sestre Milosrdnice University Hospital Center, Zagreb, Croatia
Zdravko Babić ; University of Zagreb School of Medicine, Zagreb, Croatia
Ana Đuzel ; Department of Cardiology, Sestre Milosrdnice University Hospital Center, Zagreb, Croatia
Krešimir Crljenko ; Department of Cardiology, Sestre Milosrdnice University Hospital Center, Zagreb, Croatia
Mislav Nedić ; Department of Cardiology, Sestre Milosrdnice University Hospital Center, Zagreb, Croatia
Diana Delić Brkljačić ; University of Zagreb School of Medicine, Zagreb, Croatia

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Abstract

Aim To determine whether therapeutic hypothermia (TH)
improves survival and neurological outcomes in out-ofhospital 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 primary 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 outcomes, suggesting that TH is a vital treatment option for
comatose OHCA survivors.

Keywords

Hrčak ID:

278011

URI

https://hrcak.srce.hr/278011

Publication date:

24.12.2020.

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