title: Cardiac arrest due to accidental hypothermia--a 20 year review of a rare condition in an urban area.
abstract: BACKGROUND
  Accidental hypothermic cardiac arrest is associated with unfortunate prognosis and large studies are rare. We therefore have performed an outcome analysis in patients that were admitted to Vienna University Hospital with the diagnosis of accidental hypothermic cardiac arrest.
  
  
  METHODS
  This study employed a retrospective outcome analysis of prospectively collected data in a selected cohort of hypothermic cardiac arrest patients. We screened 3800 cardiac arrest patients, treated at our department between 1991 and 2010, for eligibility. Inclusion criteria were cardiac arrest with a body core temperature ≤28 °C and return of spontaneous circulation.
  
  
  RESULTS
  A total of 18 patients who achieved return of spontaneous circulation were analysed. Nine patients (50%) achieved survival in good neurologic condition (defined as cerebral performance category CPC 1 or 2). Accidental hypothermia with consecutive cardiac arrest was caused by intoxication in most cases (67%). These patients had a better outcome than patients with other causes of accidental hypothermic cardiac arrest (OR=28; 95%KI 2-37.9; p<0.01). Hypothermia associated typical ECG changes after return of spontaneous circulation (Osborne waves) were more frequent in the surviving population (OR 16; 95%KI 1.3-19.5; p=0.05).
  
  
  CONCLUSIONS
  Accidental hypothermic cardiac arrest in a central European urban area is rare. Prognosis was excellent in patients where hypothermic cardiac arrest was caused by intoxication.
authors: Department of Emergency Medicine, Medical University of Vienna, Austria.
authors: A
authors: A
authors: Schober
authors: Department of Emergency Medicine, Medical University of Vienna, Austria. Electronic address: fritz.sterz@meduniwien.ac.at.
authors: F
authors: F
authors: Sterz
authors: Department of Emergency Medicine, Medical University of Vienna, Austria; Department of Clinical Pharmacology, Medical University of Vienna, Austria.
authors: C
authors: C
authors: Handler
authors: Department of Emergency Medicine, Medical University of Vienna, Austria.
authors: I
authors: I
authors: Kürkciyan
authors: Department of Emergency Medicine, Medical University of Vienna, Austria.
authors: A
authors: A
authors: Laggner
authors: Department of Emergency Medicine, Medical University of Vienna, Austria.
authors: M
authors: M
authors: Röggla
authors: Department of Clinical Pharmacology, Medical University of Vienna, Austria.
authors: M
authors: M
authors: Schwameis
authors: Department of Emergency Medicine, Medical University of Vienna, Austria.
authors: C
authors: C
authors: Wallmueller
authors: Department of Emergency Medicine, Medical University of Vienna, Austria.
authors: C
authors: C
authors: Testori
mesh_terms: D000328:Adult; D005260:Female; D006323:Heart Arrest / Q000209:etiology* / Q000628:therapy; D006801:Humans; D007035:Hypothermia / Q000150:complications*; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D012189:Retrospective Studies; D013997:Time Factors; D014504:Urban Health
keywords: Assessment, patient outcomes; Heart arrest; Hypothermia, accidental; Medicine, emergency; Resuscitation