• Ann Acad Med Singap · Mar 2020

    Observational Study

    Mortality and Neurological Outcomes in Out-of-Hospital Cardiac Arrest Patients With and Without Targeted Temperature Management in a Multiethnic Asian Population.

    • Wan Jing Tay, Huihua Li, Andrew Fw Ho, Ching Hui Sia, Georgina Gj Kwek, Sohil Pothiawala, Nur Shahidah, Kenneth Bk Tan, Aaron Sl Wong, Duu Wen Sewa, Eric Ts Lim, Chee Tang Chin, and Marcus Eh Ong.
    • Department of Emergency Medicine, Singapore General Hospital, Singapore.
    • Ann Acad Med Singap. 2020 Mar 1; 49 (3): 127-136.

    IntroductionThe use of targeted temperature management (TTM) is increasing although adoption is still variable. We describe our 6-year experience and compare the mortality and neurological outcomes of out-of-hospital cardiac arrest (OHCA) patients with and without the use of TTM in a multiethnic Asian population.Materials And MethodsWe performed 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.ResultsA 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 initial arrest 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.ConclusionAdoption 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.

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