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KMID : 1100620140010010019
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Clinical and Experimental Emergency Medicine
2014 Volume.1 No. 1 p.19 ~ p.27
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Outcome and current status of therapeutic hypothermia after out-of-hospital cardiac arrest in Korea using data from the Korea Hypothermia Network registry
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Lee Byung-Kook
Park Kyu-Nam
Kang Gu-Hyun
Kim Kyung-Hwan
Kim Gi-Woon
Kim Won-Young
Min Jin-Hong
Park Yoo-Seok
Park Jung-Bae
Suh Gil-Joon
Son Yoo-Dong
Shin Jong-Hwan
Oh Joo-Suk
You Yeon-Ho
Lee Dong-Hoon
Lee Jong-Seok
Lim Hoon
Jang Tae-Chang
Cho Gyu-Chong
Cho In-Soo
Cha Kyoung-Chul
Choi Seung-Pill
Choi Wook-Jin
Han Chul
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Abstract
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Objective:Therapeutic hypothermia (TH) has become the standard strategy for reducing brain damage in the postresuscitation period. The aim of this study was to investigate current TH performance and outcomes in out-of-hospital cardiac arrest (OHCA) survivors using data from the Korean Hypothermia Network (KORHN) registry.
Methods:We used the KORHN registry, a web-based multicenter registry that includes 24 participating hospitals throughout the Republic of Korea. Adult comatose OHCA survivors treated with TH between 2007 and 2012 were included. The primary outcomes were neurological outcome at hospital discharge and in-hospital mortality. The secondary outcomes were TH performance and adverse events during TH.
Results:A total of 930 patients were included, of whom 556 (59.8%) survived to discharge and 249 (26.8%) were discharged with good neurologic outcomes. The median time from return of spontaneous circulation (ROSC) to the start of TH was 101 minutes (interquartile range [IQR], 46 to 200 minutes). The induction, maintenance, and rewarming durations were 150 minutes (IQR, 80 to 267 minutes), 1,440 minutes (IQR, 1,290 to 1,440 minutes), and 708 minutes (IQR, 420 to 900 minutes), respectively. The time from the ROSC to coronary angiography was 1,045 hours (IQR, 121 to 12,051 hours). Hyperglycemia (46.3%) was the most frequent adverse event.
Conclusion:More than one-quarter of the OHCA survivors (26.8%) were discharged with good neurologic outcomes. TH performance was appropriately managed in terms of the factors related to its timing, including cooling start time and rewarming duration.
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KEYWORD
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Out-of-hospital cardiac arrest, Hypothermia, induced, Registries
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