Outcomes of Targeted Temperature Management for In-Hospital and Out-Of-Hospital Cardiac Arrest: A Matched Case-Control Study Using the National Database of Taiwan Network of Targeted Temperature Management for Cardiac Arrest (TIMECARD) Registry
Journal
Medical science monitor : international medical journal of experimental and clinical research
Journal Volume
27
Date Issued
2021-07-10
Author(s)
Abstract
BACKGROUND This study aimed to compare outcomes of targeted temperature management (TTM) for patients with in-hospital and out-of-hospital cardiac arrest using the national database of TaIwan network of targeted temperature ManagEment for CARDiac arrest (TIMECARD) registry. MATERIAL AND METHODS A retrospective, matched, case-control study was conducted. Patients with in-hospital cardiac arrest (IHCA) treated with TTM after the return of spontaneous circulation (ROSC) were selected as the case group and controls were defined as the same number of patients with out-of-hospital cardiac arrest (OHCA), matched for sex, age, Charlson comorbidity index, and cerebral performance category. Neurological outcome and survival at hospital discharge were the primary outcome measures. RESULTS Data of 103 patients with IHCA and matched controls with OHCA were analyzed. Patients with IHCA were more likely to experience witnessed arrest and bystander cardiopulmonary resuscitation (CPR). The duration from collapse to the beginning of CPR, CPR time, and the duration from ROSC to initiation of TTM were shorter in the IHCA group but their initial arterial blood pressure after ROSC was lower. Overall, 88% of patients survived to completion of TTM and 43% survived to hospital discharge. Hospital survival (42.7% vs 42.7%, P=1.00) and favorable neurological outcome at discharge (19.4% vs 12.7%, P=0.25) did not differ between the 2 groups. CONCLUSIONS The findings from the national TIMECARD registry showed that clinical outcomes following TTM for patients with IHCA were not significantly different from OHCA when baseline factors were matched.
Subjects
Hypothermia, Induced | Out-of-Hospital Cardiac Arrest | Post-Cardiac Arrest Syndrome
SDGs
Other Subjects
clopidogrel; epinephrine; troponin I; adult; arterial pressure; Article; artificial ventilation; central venous pressure; Charlson Comorbidity Index; computer assisted tomography; controlled study; diastolic blood pressure; echocardiography; electrophysiology; extracorporeal oxygenation; female; Glasgow coma scale; heart arrest; heart arrhythmia; heart rate; heart ventricle fibrillation; heart ventricle tachycardia; hemodialysis; hospital mortality; human; hypothermia; intensive care unit; length of stay; major clinical study; male; mean arterial pressure; post-cardiac arrest syndrome; propensity score; prospective study; reperfusion injury; resuscitation; retrospective study; return of spontaneous circulation; risk factor; systolic blood pressure; tachycardia; thorax injury; aged; case control study; emergency health service; factual database; hospital; hospital discharge; induced hypothermia; middle aged; out of hospital cardiac arrest; register; Taiwan; Adult; Aged; Cardiopulmonary Resuscitation; Case-Control Studies; Databases, Factual; Emergency Medical Services; Hospitals; Humans; Hypothermia, Induced; Middle Aged; Out-of-Hospital Cardiac Arrest; Patient Discharge; Registries; Retrospective Studies; Taiwan
Type
journal article