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
Charles Maynard, W T Longstreth Jr, Graham Nichol, Al Hallstrom, Peter J Kudenchuk, Thomas Rea, Michael K Copass, David Carlbom, Steven Deem, Michele Olsufka, Leonard A Cobb, Francis Kim, Charles Maynard, W T Longstreth Jr, Graham Nichol, Al Hallstrom, Peter J Kudenchuk, Thomas Rea, Michael K Copass, David Carlbom, Steven Deem, Michele Olsufka, Leonard A Cobb, Francis Kim
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.
Methods and 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.
Conclusion: 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.
Clinical trial registration: URL: Clinicaltrials.gov. Unique identifier: NCT00391469.
Keywords: arrhythmia; cardiac arrest; follow‐up study.
© 2015 The Authors. Published on behalf of the American Heart Association, Inc., by Wiley Blackwell.
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Source: PubMed