Department of Emergency Medicine, Kangnam Sacred Heart Hospital, Hallym University College of Medicine, Seoul, Republic of Korea.
Medicine (Baltimore). 2022 Feb 4;101(5):e28688. doi: 10.1097/MD.0000000000028688.
This study aimed to evaluate the prognostic significance of targeted temperature management (TTM) on hanging-induced out-of-hospital cardiac arrest (OHCA) patients using nationwide data of South Korea.Adult hanging-induced OHCA patients from 2008 to 2018 were included in this nationwide observational study. Patients who assigned into 2 groups based on whether they did (TTM group) or did not (non-TTM group) receive TTM. Outcome measures included survival to hospital discharge and a good neurological outcome at hospital discharge.Among the 293,852 OHCA patients, 3545 patients (non-TTM, n = 2762; TTM, n = 783) were investigated. After propensity score matching for all patients, 783 matched pairs were available for analysis. We observed no significant inter-group differences in the survival to hospital discharge (non-TTM, n = 27 [3.4%] vs TTM, n = 23 [2.9%], P = .666) or good neurological outcomes (non-TTM, n = 23 [2.9%] vs TTM, n = 14 [1.8%], P = .183). In the multivariate analysis, prehospital return of spontaneous circulation (odds ratio [OR], 22.849; 95% confidence interval [CI], 11.479-45.481, P < .001) was associated with an increase in survival to hospital discharge, and age (OR, 0.971; 95% CI, 0.944-0.998, P = .035), heart disease (OR, 16.875; 95% CI, 3.028-94.036, P = .001), and prehospital return of spontaneous circulation (OR, 133.251; 95% CI, 30.512-581.930, P < .001) were significant prognostic factors of good neurological outcome. However, TTM showed no significant association with either outcome.There were no significant differences in the survival to hospital discharge and good neurological outcomes between non-TTM and TTM groups of hanging-induced OHCA patients.
本研究旨在利用韩国全国性数据评估目标体温管理（TTM）对悬挂致院外心脏骤停（OHCA）患者的预后意义。
该全国性观察性研究纳入了 2008 年至 2018 年期间因悬挂致 OHCA 的成年患者。根据是否接受 TTM（TTM 组）或未接受 TTM（非 TTM 组）将患者分为 2 组。观察指标包括出院时的生存率和出院时的良好神经功能结局。
在纳入的 293852 例 OHCA 患者中，有 3545 例（非 TTM 组 n=2762；TTM 组 n=783）进行了研究。对所有患者进行倾向评分匹配后，可用于分析的匹配对为 783 对。我们观察到出院时的生存率（非 TTM 组 n=27[3.4%] vs TTM 组 n=23[2.9%]，P=0.666）或良好神经功能结局（非 TTM 组 n=23[2.9%] vs TTM 组 n=14[1.8%]，P=0.183）两组间无显著差异。多变量分析显示，院前自主循环恢复（优势比[OR]，22.849；95%置信区间[CI]，11.479-45.481，P<0.001）与出院时生存率增加相关，而年龄（OR，0.971；95%CI，0.944-0.998，P=0.035）、心脏病（OR，16.875；95%CI，3.028-94.036，P=0.001）和院前自主循环恢复（OR，133.251；95%CI，30.512-581.930，P<0.001）是良好神经功能结局的显著预后因素。然而，TTM 与这两个结局均无显著相关性。
悬挂致 OHCA 患者的非 TTM 组和 TTM 组在出院时的生存率和良好神经功能结局方面无显著差异。
