Association between initial body temperature on hospital arrival and neurological outcome among patients with out-of-hospital cardiac arrest: a multicenter cohort study (the CRITICAL study in Osaka, Japan)

Autor: Satoshi Yoshimura, Takeyuki Kiguchi, Taro Irisawa, Tomoki Yamada, Kazuhisa Yoshiya, Changhwi Park, Tetsuro Nishimura, Takuya Ishibe, Yoshiki Yagi, Masafumi Kishimoto, Sung-Ho Kim, Yasuyuki Hayashi, Taku Sogabe, Takaya Morooka, Haruko Sakamoto, Keitaro Suzuki, Fumiko Nakamura, Tasuku Matsuyama, Yohei Okada, Norihiro Nishioka, Satoshi Matsui, Shunsuke Kimata, Shunsuke Kawai, Yuto Makino, Tetsuhisa Kitamura, Taku Iwami, on behalf of the, CRITICAL Study Group Investigators
Jazyk: angličtina
Rok vydání: 2022
Předmět:
Zdroj: BMC Emergency Medicine, Vol 22, Iss 1, Pp 1-10 (2022)
Druh dokumentu: article
ISSN: 1471-227X
DOI: 10.1186/s12873-022-00641-5
Popis: Abstract Background The association between spontaneous initial body temperature on hospital arrival and neurological outcomes has not been sufficiently studied in patients after out-of-hospital cardiac arrest (OHCA). Methods From the prospective database of the Comprehensive Registry of Intensive Care for OHCA Survival (CRITICAL) study in Osaka, Japan, we enrolled all patients with OHCA of medical origin aged > 18 years for whom resuscitation was attempted and who were transported to participating hospitals between 2012 and 2019. We excluded patients who were not witnessed by bystanders and treated by a doctor car or helicopter, which is a car/helicopter with a physician. The patients were categorized into three groups according to their temperature on hospital arrival: ≤35.9 °C, 36.0–36.9 °C (normothermia), and ≥ 37.0 °C. The primary outcome was 1-month survival, with a cerebral performance category of 1 or 2. Multivariable logistic regression analyses were performed to evaluate the association between temperature and outcomes (normothermia was used as the reference). We also assessed this association using cubic spline regression analysis. Results Of the 18,379 patients in our database, 5014 witnessed adult OHCA patients of medical origin from 16 hospitals were included. When analyzing 3318 patients, OHCA patients with an initial body temperature of ≥37.0 °C upon hospital arrival were associated with decreased favorable neurological outcomes (6.6% [19/286] odds ratio, 0.51; 95% confidence interval, 0.27–0.95) compared to patients with normothermia (16.4% [180/1100]), whereas those with an initial body temperature of ≤35.9 °C were not associated with decreased favorable neurological outcomes (11.1% [214/1932]; odds ratio, 0.78; 95% confidence interval, 0.56–1.07). The cubic regression splines demonstrated that a higher body temperature on arrival was associated with decreased favorable neurological outcomes, and a lower body temperature was not associated with decreased favorable neurological outcomes. Conclusions In adult patients with OHCA of medical origin, a higher body temperature on arrival was associated with decreased favorable neurologic outcomes.
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