title: Effect of prehospital induction of mild hypothermia on 3-month neurological status and 1-year survival among adults with cardiac arrest: long-term follow-up of a randomized, clinical trial.
abstract: BACKGROUND
  Randomized trials of prehospital cooling after cardiac arrest have shown that neither prehospital cooling nor targeted temperature management differentially affected short-term survival or neurological function. In this follow-up study, we assess the association of prehospital hypothermia with neurological function at least 3 months after cardiac arrest and survival 1 year after cardiac arrest.
  
  
  RESULTS
  There were 508 individuals who were discharged alive from hospitals in King County, Washington; 373 (73%) were interviewed by telephone 123±43 days after the initial event. Overall, 59% of the treatment group and 58% of the control group had Cerebral Performance Category (CPC) 1 or 2 (P=0.70), and 50% of the treatment group and 49% of the control group had slight disability or better by the Modified Rankin Scale (MRS; (P=0.35). One-year survival was 87% in the treatment group and 84% in the control group (P=0.42). Of those with CPC 1 at hospital discharge, 68% had CPC 1 or 2 at follow-up, and 59% had MRS of slight disability or better. Of 41 patients with CPC 3 or 4 at discharge, only 12% had CPC 2 at follow-up, and just 5% had MRS of slight disability or better. One-year survival was 92% for CPC 1 at discharge, but only 40% for CPC 4.
  
  
  CONCLUSIONS
  In addition to excellent survival, patients who had good neurological function at discharge continued to have good function at least 3 months after the event.
  
  
  BACKGROUND
  URL: Clinicaltrials.gov. Unique identifier: NCT00391469.
authors.affiliation: Department of Health Services, School of Public Health, University of Washington, Seattle, WA (C.M.).
authors.forename: Charles
authors.initials: C
authors.lastname: Maynard
authors.affiliation: Department of Epidemiology, School of Public Health, University of Washington, Seattle, WA (L.) Department of Neurology, School of Medicine, University of Washington, Seattle, WA (L., M.K.C.).
authors.forename: W T
authors.initials: WT
authors.lastname: Longstreth
authors.affiliation: Department of Medicine, School of Medicine, University of Washington, Seattle, WA (G.N., P.J.K., T.R., D.C., M.O., L.A.C., F.K.).
authors.forename: Graham
authors.initials: G
authors.lastname: Nichol
authors.affiliation: Department of Biostatistics, School of Public Health, University of Washington, Seattle, WA (A.H.).
authors.forename: Al
authors.initials: A
authors.lastname: Hallstrom
authors.affiliation: Department of Medicine, School of Medicine, University of Washington, Seattle, WA (G.N., P.J.K., T.R., D.C., M.O., L.A.C., F.K.).
authors.forename: Peter J
authors.initials: PJ
authors.lastname: Kudenchuk
authors.affiliation: Department of Medicine, School of Medicine, University of Washington, Seattle, WA (G.N., P.J.K., T.R., D.C., M.O., L.A.C., F.K.).
authors.forename: Thomas
authors.initials: T
authors.lastname: Rea
authors.affiliation: Department of Neurology, School of Medicine, University of Washington, Seattle, WA (L., M.K.C.).
authors.forename: Michael K
authors.initials: MK
authors.lastname: Copass
authors.affiliation: Department of Medicine, School of Medicine, University of Washington, Seattle, WA (G.N., P.J.K., T.R., D.C., M.O., L.A.C., F.K.).
authors.forename: David
authors.initials: D
authors.lastname: Carlbom
authors.affiliation: Swedish Medical Center, Seattle, WA (S.D.).
authors.forename: Steven
authors.initials: S
authors.lastname: Deem
authors.affiliation: Department of Medicine, School of Medicine, University of Washington, Seattle, WA (G.N., P.J.K., T.R., D.C., M.O., L.A.C., F.K.).
authors.forename: Michele
authors.initials: M
authors.lastname: Olsufka
authors.affiliation: Department of Medicine, School of Medicine, University of Washington, Seattle, WA (G.N., P.J.K., T.R., D.C., M.O., L.A.C., F.K.).
authors.forename: Leonard A
authors.initials: LA
authors.lastname: Cobb
authors.affiliation: Department of Medicine, School of Medicine, University of Washington, Seattle, WA (G.N., P.J.K., T.R., D.C., M.O., L.A.C., F.K.).
authors.forename: Francis
authors.initials: F
authors.lastname: Kim
mesh_terms: D000368:Aged; D004185:Disability Evaluation; D004632:Emergency Medical Services / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007036:Hypothermia, Induced / Q000009:adverse effects / Q000401:mortality; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D009420:Nervous System / Q000503:physiopathology*; D009460:Neurologic Examination; D058687:Out-of-Hospital Cardiac Arrest / Q000175:diagnosis / Q000401:mortality / Q000503:physiopathology / Q000628:therapy*; D010351:Patient Discharge; D011237:Predictive Value of Tests; D011446:Prospective Studies; D020127:Recovery of Function; D012307:Risk Factors; D013997:Time Factors; D016896:Treatment Outcome; D014861:Washington
keywords: arrhythmia; cardiac arrest; follow‐up study