title: Therapeutic hypothermia after cardiac arrest caused by self-inflicted intoxication: a multicenter retrospective cohort study.
abstract: BACKGROUND
  The aim of this study was to describe the epidemiology and outcomes of patients with therapeutic hypothermia after out-of-hospital cardiac arrest (OHCA) caused by self-inflicted intoxication.
  
  
  METHODS
  We performed a multicenter retrospective registry-based study of adult OHCA patients presenting to 24 hospitals over 6 years across South Korea. Data included demographics, resuscitation variables, postresuscitation variables, and self-inflicted intoxicants. Neurologic outcomes were categorized according to the Glasgow-Pittsburgh Cerebral Performance Categories (CPC) scale and were dichotomized as either good discharge outcomes (CPC 1 and 2) or poor discharge outcomes (CPC 3-5).
  
  
  RESULTS
  A total of 930 OHCA cases were identified, 24 (2.6%) of which were classified as cardiac arrest caused by acute intoxication. The mean age of cases was 57.2 ± 12.9 years. The mean time from collapse to return of spontaneous circulation was 35.4 ± 18.7 minutes. The presenting rhythm was pulseless electrical activity in 6 patients (25%) and asystole in 18 patients (75%). Eleven patients (46%) survived to hospital discharge, and of these, good discharge outcomes (CPC 1 and 2) were achieved in 21% (5/24). For pesticide intoxication, the survival-to-discharge rate was 62% (8/13), and the rate of good neurologic outcome was 23% (3/13).
  
  
  CONCLUSIONS
  Patients with OHCA caused by self-inflicted intoxication represented 2.6% of all OHCA patients. They showed a high rate of unwitnessed cardiac arrest and a very low rate of bystander cardiopulmonary resuscitation. Pesticides were the main cause of cardiac arrest, and these cases had a very high discharge to survival rate.
authors.affiliation: Department of Emergency Medicine, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea.
authors.forename: Han Joon
authors.initials: HJ
authors.lastname: Kim
authors.affiliation: Department of Emergency Medicine, College of Medicine, Ajou University, Suwon, Republic of Korea. Electronic address: flyingguy@ajou.ac.kr.
authors.forename: Gi Woon
authors.initials: GW
authors.lastname: Kim
authors.affiliation: Department of Emergency Medicine, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea.
authors.forename: Sang Hoon
authors.initials: SH
authors.lastname: Oh
authors.affiliation: Department of Emergency Medicine, Seoul Medical Center, Seoul, Republic of Korea.
authors.forename: Sang Hyun
authors.initials: SH
authors.lastname: Park
authors.affiliation: Department of Emergency Medicine, College of Medicine, Soonchunhyang University, Bucheon, Republic of Korea.
authors.forename: Jae Hyung
authors.initials: JH
authors.lastname: Choi
authors.affiliation: Department of Emergency Medicine, College of Medicine, Inje University, Ilsan, Republic of Korea.
authors.forename: Kyung Hwan
authors.initials: KH
authors.lastname: Kim
authors.affiliation: Department of Emergency Medicine, College of Medicine, Inje University, Ilsan, Republic of Korea.
authors.forename: Woo Chan
authors.initials: WC
authors.lastname: Jeon
authors.affiliation: Department of Emergency Medicine, College of Medicine, Seoul National University, Seoul, Republic of Korea.
authors.forename: Hui Jai
authors.initials: HJ
authors.lastname: Lee
authors.affiliation: Department of Emergency Medicine, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea.
authors.forename: Kyu Nam
authors.initials: KN
authors.lastname: Park
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016887:Cardiopulmonary Resuscitation; D005260:Female; D006801:Humans; D007036:Hypothermia, Induced; D008297:Male; D008875:Middle Aged; D058687:Out-of-Hospital Cardiac Arrest / Q000139:chemically induced* / Q000628:therapy*; D011041:Poisoning / Q000150:complications*; D012042:Registries; D056910:Republic of Korea; D012189:Retrospective Studies; D013406:Suicide, Attempted; D015996:Survival Rate; D061665:Time-to-Treatment; D016896:Treatment Outcome