Shock Severity and Hospital Mortality In Out of Hospital Cardiac Arrest Patients Treated With Targeted Temperature Management

BACKGROUND:Shock in patients resuscitated after out of hospital cardiac arrest (OHCA) is associated with an increased risk of mortality. We sought to determine the associations between lactate level, mean arterial pressure (MAP), and vasopressor/inotrope doses with mortality. METHODS:Retrospective c...

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Bibliographic Details
Published in:Shock (Augusta, Ga.) Ga.), 2021-01, Vol.55 (1), p.48-54
Main Authors: Tabi, Meir, Burstein, Barry J., Ahmed, Abdelrahman, Dezfulian, Cameron, Kashani, Kianoush B., Jentzer, Jacob C.
Format: Article
Language:English
Subjects:
Aged
Arterial Pressure
Female
Hospital Mortality
Humans
Hypothermia, Induced
Lactic Acid - blood
Logistic Models
Male
Middle Aged
Out-of-Hospital Cardiac Arrest - complications
Out-of-Hospital Cardiac Arrest - mortality
Out-of-Hospital Cardiac Arrest - therapy
Retrospective Studies
Risk Factors
Severity of Illness Index
Shock, Cardiogenic - etiology
Shock, Cardiogenic - mortality
Shock, Cardiogenic - therapy
Vasoconstrictor Agents - therapeutic use
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Summary:BACKGROUND:Shock in patients resuscitated after out of hospital cardiac arrest (OHCA) is associated with an increased risk of mortality. We sought to determine the associations between lactate level, mean arterial pressure (MAP), and vasopressor/inotrope doses with mortality. METHODS:Retrospective cohort study of adult patients with OHCA of presumed cardiac etiology treated with targeted temperature management (TTM) between December 2005 and September 2016. Multivariable logistic regression was performed to determine predictors of hospital death. RESULTS:Among 268 included patients, the median age was 64 (55, 71.8) years, including 27% females. Witnessed arrest in 89%, shockable rhythm in 87%, and 64% received bystander CPR. Vasopressors were required during the first 24 hours in 60%. Hospital mortality occurred in 104 (38.8%) patients. Higher initial lactate, peak Vasoactive-Inotropic Score (VIS) and lower mean 24-hour MAP were associated with higher hospital mortality (all p 
ISSN:1073-2322
1540-0514
DOI:10.1097/SHK.0000000000001600