title: Therapeutic hypothermia is independently associated with favourable outcome after resuscitation from out-of-hospital cardiac arrest: a retrospective, observational cohort study.
abstract: OBJECTIVE
  To determine the association between use of therapeutic hypothermia (TH) after resuscitation from out-of-hospital cardiac arrest (OHCA) and neurological outcome.
  
  
  METHODS
  Retrospective observational cohort study in a tertiary university-associated Level III general ICU of 179 ICU patients in three cohorts ('pre' hypothermia: 58 patients, 'post' hypothermia 69 patients, 'recent' 52 patients) admitted between 1 January, 2009, and 15 April, 2011, after resuscitation from OHCA.
  
  
  METHODS
  TH to 33C for 12 hours.
  
  
  METHODS
  Favourable neurological outcome (transferred home) at hospital discharge.
  
  
  RESULTS
  The frequency of bystander CPR increased (38/58, 56/69, 47/52, p=0.04), as did the use of TH (0/58, 25/69, 39/52, p<0.00001) and the frequency of favourable neurological outcome between the three cohorts (21/58, 28/69, 32/52, p=0.02). The cohorts were similar in age, gender, shockable rhythm and time to ROSC. In multivariate analysis, favourable neurological outcome was independently associated with younger age (in 5-year intervals, OR 0.78 [0.67-0.90], p=0.001), bystander CPR (OR 4.8 [1.5-15], p=0.007), shockable rhythm (OR 3.5 [1.1-11], p=0.04), time to ROSC (OR 0.90 [0.86-0.94], p<0.0005) and use of TH (OR 2.8 [1.2-6.2], p=0.01).
  
  
  CONCLUSIONS
  The use of TH in patients admitted to ICU after resuscitation following OHCA was independently associated with favourable neurological outcome.
authors.affiliation: Intensivist and Anaesthetist, Department of Critical Care Medicine, Auckland City Hospital, Private Bag 92024, Auckland Mail Centre, Auckland 1142. Kerrybc@adhb.govt.nz.
authors.forename: Kerry A
authors.initials: KA
authors.lastname: Benson-Cooper
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D044362:Australasia / Q000453:epidemiology; D016887:Cardiopulmonary Resuscitation / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007036:Hypothermia, Induced / Q000379:methods*; D008297:Male; D008875:Middle Aged; D058687:Out-of-Hospital Cardiac Arrest / Q000401:mortality / Q000628:therapy*; D011446:Prospective Studies; D015996:Survival Rate / Q000639:trends; D013997:Time Factors; D016896:Treatment Outcome; D055815:Young Adult