Relationship between cooling time and neurological outcomes in targeted temperature management

• Published in: Academic emergency medicine 2022-06, Vol.29 (6), p.729-735
• Main Authors: Ahn, Seong Jun, Kim, Yong Hwan, Lee, Jun Ho, Lee, Dong Woo, Hwang, Seong Youn, Lee, Byung Kook, Cho, In Soo, Oh, Sang Hoon, Cha, Kyoung‐Chul
• Format: Article
• Language: English
• Subjects: Body temperature; Clinical outcomes; Cold; Emergency medical care; heart arrest; Heart attacks; induced hypothermia; Medical prognosis; Neurology; prognosis; Regression analysis
• ISSN: 1069-6563; 1553-2712
• DOI: 10.1111/acem.14440

Objectives The relationship between cooling time (CT) variables and neurological outcomes is controversial. We evaluated the relationship between CT and neurological outcomes in out‐of‐hospital cardiac arrest (OHCA) patients treated with targeted temperature management (TTM). Methods We conducted a multicenter, prospective, and registry‐based study of OHCA survivors treated with TTM. CT was defined as the time from restoration of spontaneous circulation to achievement of the target temperature. The primary outcome was a favorable neurological outcome at 6 months. Multilevel logistic regression analysis was performed to test the relationship between CT and the primary outcome. Results Overall, the favorable neurological outcome rates at 6 months were 29.8% in 937 patients. When CT was stratified into categories of 0–3, 3.1–6, 6.1–9, 9.1–12, and >12 h, according to 3‐h intervals, the primary outcome rates were 8.2%, 22.7%, 35.5%, 44.7%, and 44.5%, respectively (p