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Mild induced hypothermia and survival after out-of-hospital cardiac arrest.
Sahlgrenska Academy, University of Gothenburg.
University of Borås, Faculty of Caring Science, Work Life and Social Welfare.ORCID iD: 0000-0003-4139-6235
Sahlgrenska Academy, University of Gothenburg.
Lund University.
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2017 (English)In: American Journal of Emergency Medicine, ISSN 0735-6757, E-ISSN 1532-8171, Vol. 35, no 11, p. 1595-1600, article id S0735-6757(17)30335-2Article in journal (Refereed) Published
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Abstract [en]

BACKGROUND: Mild induced hypothermia (MIH) was introduced for post cardiac arrest care in Sweden in 2003, based on two clinical trials. This retrospective study evaluated its association with 30-day survival after out-of-hospital cardiac arrest (OHCA) in a Swedish community from 2003 to 2015.

METHODS: Out of 3680 patients with OHCA, 1100 were hospitalized after return of spontaneous circulation and 871 patients who remained unconscious were included in the analysis. Prehospital data were extracted from the Swedish Registry of Cardiopulmonary Resuscitation and in-hospital data were extracted from clinical records. Propensity score analysis on complete data sets and multivariable logistic regression with multiple imputations to compensate for missing data were performed.

RESULTS: Unadjusted 30-day survival was 23.5%; 37% in 386/871 (44%) MIH treated and 13% in 485/871 (56%) non-MIH treated patients. Unadjusted odds ratio (OR) for 30-day survival in patients treated with MIH compared to non-MIH treated patients was 3.79 (95% CI 2.71-5.29; p<0.0001). Using stratified propensity score analysis and in addition adjusting for in-hospital factors, 30-day survival was not significantly different in patients treated with MIH compared to non-MIH treated patients; OR 1.33 (95% CI 0.83-2.15; p=0.24). Using multiple imputations to handle missing data yielded a similar adjusted OR of 1.40 (95% CI 0.88-2.22; p=0.15). Good neurologic outcome at hospital discharge was seen in 82% of patients discharged alive.

CONCLUSION: Treatment with MIH was not significantly associated with increased 30-day survival in patients remaining unconscious after OHCA when adjusting for potential confounders.

Place, publisher, year, edition, pages
2017. Vol. 35, no 11, p. 1595-1600, article id S0735-6757(17)30335-2
Keywords [en]
Mild induced hypothermia, Out-of-hospital cardiac arrest, Survival
National Category
Clinical Medicine
Research subject
Människan i vården
Identifiers
URN: urn:nbn:se:hb:diva-13335DOI: 10.1016/j.ajem.2017.04.071ISI: 000415201700002PubMedID: 28465012Scopus ID: 2-s2.0-85018416718OAI: oai:DiVA.org:hb-13335DiVA, id: diva2:1170692
Available from: 2018-01-04 Created: 2018-01-04 Last updated: 2018-01-04Bibliographically approved

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