J Korean Med Sci.  2014 Sep;29(9):1301-1307. 10.3346/jkms.2014.29.9.1301.

Survival and Neurologic Outcomes of Out-of-Hospital Cardiac Arrest Patients Who Were Transferred after Return of Spontaneous Circulation for Integrated Post-Cardiac Arrest Syndrome Care: The Another Feasibility of the Cardiac Arrest Center

• Kang MJ
• Lee TR
• Shin TG
• Sim MS
• Jo IJ
• Song KJ
• Jeong YK

• KMID: 1794611
• DOI: http://doi.org/10.3346/jkms.2014.29.9.1301

Abstract

It has been proven that safety and efficiency of out-of-hospital cardiac arrest (OHCA) patients is transported to specialized hospitals that have the capability of performing therapeutic hypothermia (TH). However, the outcome of the patients who have been transferred after return of spontaneous circulation (ROSC) has not been well evaluated. We conducted a retrospective observational study between January 2010 to March 2012. There were primary outcomes as good neurofunctional status at 1 month and the secondary outcomes as the survivals at 1 month between Samsung Medical Center (SMC) group and transferred group. A total of 91 patients were enrolled this study. There was no statistical difference between good neurologic outcomes between both groups (38% transferred group vs. 40.6% SMC group, P=0.908). There was no statistical difference in 1 month survival between the 2 groups (66% transferred group vs. 75.6% SMC group, P=0.318). In the univariate and multivariate models, the ROSC to induction time and the induction time had no association with good neurologic outcomes. The good neurologic outcome and survival at 1 month had no significant differences between the 2 groups. This finding suggests the possibility of integrated post-cardiac arrest care for OHCA patients who are transferred from other hospitals after ROSC in the cardiac arrest center.

Keyword

Hypothermia Therapy; Heart Arrest; Cardiopulmonary Resuscitation

MeSH Terms

Adult
Aged
Cardiopulmonary Resuscitation
Electrocardiography
Female
Heart Arrest/*mortality
Humans
Hypothermia, Induced
Kaplan-Meier Estimate
Logistic Models
Male
Middle Aged
Odds Ratio
Out-of-Hospital Cardiac Arrest
Retrospective Studies
Tomography, X-Ray Computed

Figure

• 

  Fig. 1 Diagram of defined time variables for both groups. CPR, Cardiopulmonary resuscitation; ROSC, Return of spontaneous circulation; ED, Emergency department; SMC, Samsung medical center; BT, Body temperature.

• 

  Fig. 2 The Kaplan-Meier survival curve of both groups. The log rank test in both groups (P = 0.333).

• 

  Fig. 3 Scatter plot of patient initial body temperature for both groups. (Transferred group, standardized beta coefficients 0.49, P < 0.001 vs. SMC group, standardized beta coefficients 0.12, P = 0.438).

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