Why the study?
Abnormal initial body temperature may be linked to neurologic damage during arrest, but its association with neurologic outcomes in out-of-hospital cardiac arrest patients undergoing targeted temperature management required investigation.
Does abnormal initial body temperature prior to targeted temperature management predict worse neurologic recovery in out-of-hospital cardiac arrest patients?
Does abnormal initial body temperature prior to targeted temperature management predict worse neurologic recovery in out-of-hospital cardiac arrest patients?
Low initial body temperature (<35.5°C) prior to targeted temperature management is associated with unfavorable neurologic recovery and lower survival in out-of-hospital cardiac arrest patients.
Low initial temperature signals higher risk of poor recovery; hypothesis-generating and should not yet change TTM practice.
Objective: Targeted temperature management (TTM) is the core post-resuscitation treatment to minimize neurologic deficit after out-of-hospital cardiac arrest (OHCA). Abnormal initial body temperature (BT) can be associated with neurologic damage during arrest. We aimed to investigate the association between initial BT and neurologic outcomes of OHCA patients who underwent TTM. Methods: This study used a nationwide OHCA database from January 2013 to December 2018. Among OHCA patients older than 18 years and with cardiac etiology, those with TTM treatment were included. BT at the initiation of TTM was categorized into three groups: low (35.5C), normal (35.6C-37.4C), and high (37.5C). The primary outcome was good neurologic recovery (Cerebral Performance Category 1 or 2). The association between initial BT and outcome was assessed using multivariable logistic regression analysis. Results: A total of 1226 patients were analyzed, 354 (28.9%), 767 (62.6%), and 105 (8.6%) in the low, normal, and high BT groups, respectively. The good neurologic recovery rate was 15.0%, 39.9%, and 34.3% in these respective groups. The aOR for good neurologic recovery was 0.36 (95% confidence interval [CI], 0.25 to 0.51) in the low and 0.72 (95% CI, 0.43 to 1.22) in the high BT group compared with the normal BT group. Conclusion: Low BT at the initiation of TTM was associated with unfavorable neurologic recovery for OHCA patients who underwent TTM.
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Kim et al. (2022) studied this question.
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