• Shadman Aziz, Molly Clough, Emma Butterfield, Zachary Starr, Kate Lachowycz, James Price, BarnardEd B GEBGDepartment of Research, Audit, Innovation and Development, East Anglian Air Ambulance, Norwich.Emergency Department, Cambridge University Hospitals NHS Foundation Trust, Cambridge.Academic Department of Military Emergency Medicine, Royal C, and Paul Rees.
• Department of Research, Audit, Innovation and Development, East Anglian Air Ambulance, Norwich.
• Eur J Emerg Med. 2024 Oct 1; 31 (5): 356362356-362.

Background And ImportanceFollowing the return of spontaneous circulation (ROSC) after out-of-hospital cardiac arrest (OHCA), a low body temperature on arrival at the hospital and on admission to the ICU is reportedly associated with increased mortality. Whether this association exists in the prehospital setting, however, is unknown.ObjectiveThe objective of this study was to investigate whether the initial, prehospital core temperature measured post-ROSC is independently associated with survival to hospital discharge in adult patients following OHCA.Design, Setting And ParticipantsThis retrospective observational study was conducted at East Anglian Air Ambulance, a physician-paramedic staffed Helicopter Emergency Medical Service in the East of England, UK. Adult OHCA patients attended by East Anglian Air Ambulance from 1 February 2015 to 30 June 2023, who had post-ROSC oesophageal temperature measurements were included.Outcome Measure And AnalysisThe primary outcome measure was survival to hospital discharge. Core temperature was defined as the first oesophageal temperature recorded following ROSC. Multivariable logistic regression evaluated the adjusted association between core temperature and survival to hospital discharge.Main ResultsResuscitation was attempted in 3990 OHCA patients during the study period, of which 552 patients were included in the final analysis. The mean age was 61 years, and 402 (72.8%) patients were male. Among them, 194 (35.1%) survived to hospital discharge. The mean core temperature was lower in nonsurvivors compared with those who survived hospital discharge; 34.6 and 35.2 °C, respectively (mean difference, -0.66; 95% CI, -0.87 to -0.44; P  < 0.001). The adjusted odds ratio for survival was 1.41 (95% CI, 1.09-1.83; P  = 0.01) for every 1.0 °C increase in core temperature between 32.5 and 36.9 °C.ConclusionIn adult patients with ROSC following OHCA, early prehospital core temperature is independently associated with survival to hospital discharge.Copyright © 2024 The Author(s). Published by Wolters Kluwer Health, Inc.

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