Association between initial body temperature and neurologic outcomes of out-of-hospital cardiac arrest patients undergoing targeted temperature management

Abstract

Objective: Targeted temperature management (TTM) is the core post-resuscitation treatment to minimize neurologic deficit after out-of-hospital cardiac arrest (OHCA). Abnormal initial body temperature (BT) can be associated with neurologic damage during the arrest. We aimed to investigate the association between initial BT and neurologic outcomes of OHCA patients who underwent TTM. Methods: This study used a nationwide OHCA database from January 2013 to December 2018. Among OHCA patients with cardiac etiology over 18 years of age, patients with TTM treatment were included. BT at the initiation of TTM was categorized into three groups: low (35.5°C), normal (35.6°C−37.4°C), and high (37.5°C). The primary outcome was a good neurologic recovery (Cerebral Performance Categories 1 or 2). The association between initial BT and outcome was assessed using multivariable logistic regression analysis. Results: One thousand two hundred and twenty-six patients were analyzed, 354 (28.9%), 767 (62.6%), and 105 (8.6%) were in the low, normal, and high BT groups, respectively. Good neurologic recovery rate was 15.0%, 39.9%, and 34.3% respectively. The aOR for good neurologic recovery was 0.36 (95% confidence interval [CI], 0.25 to 0.51) in the low and 0.72 (95% CI, 0.43 to 1.22) in the high BT group compared with the normal BT group. Conclusion: Low BT at the initiation of TTM was associated with unfavorable neurologic recovery for OHCA patients who underwent TTM.