Outcome and current status of therapeutic hypothermia after out-of-hospital cardiac arrest in Korea using data from the Korea Hypothermia Network registry

Byung Kook Lee, Kyu Nam Park, Gu Hyun Kang, Kyung Hwan Kim, Giwoon Kim, Won Young Kim, Jin Hong Min, Yooseok Park, Jung Bae Park, Gil Joon Suh, Yoo Dong Son, Jonghwan Shin, Joo Suk Oh, Yeon Ho You, Dong Hoon Lee, Jong Seok Lee, Hoon Lim, Tae Chang Jang, Gyu Chong Cho, In Soo Cho, Kyoung Chul Cha, Seung Pill Choi, Wook Jin Choi, Chul Han
Clinical and Experimental Emergency Medicine 2014, 1 (1): 19-27

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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