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Observational Study
. 2022 Jul 22;17(7):e0271605.
doi: 10.1371/journal.pone.0271605. eCollection 2022.

The association of different target temperatures in targeted temperature management with neurological outcome after out-of-hospital cardiac arrest based on a prospective multicenter observational study in Korea (the KORHN-PRO registry): IPTW analysis

Hyo Joon Kim  1 , Chun Song Youn  1 , Kyu Nam Park  1 , Young-Min Kim  1 , Byung Kook Lee  2 , Kyung Woon Jeung  2 , Won Young Kim  3 , Seung Pill Choi  4 , Soo Hyun Kim  4 ; Korean Hypothermia Network Investigator
Affiliations
Observational Study

The association of different target temperatures in targeted temperature management with neurological outcome after out-of-hospital cardiac arrest based on a prospective multicenter observational study in Korea (the KORHN-PRO registry): IPTW analysis

Hyo Joon Kim et al. PLoS One. .

Abstract

Background: Among comatose survivors of out-of-hospital cardiac arrest (OHCA), targeted temperature management (TTM) has improved neurological outcomes. However, although the target temperature shifted from 33°C to 33°C~36°C, the optimal target temperature is still unclear. The goal of this study was to evaluate neurological outcomes at 6 months at target temperatures of 33°C and 36°C.

Materials and methods: We analyzed OHCA survivors who underwent TTM and were recorded in the Korean Hypothermia Network, a prospective multicenter registry, from October 2015 to December 2018. The primary outcome was good neurological outcome at six months, defined as a cerebral performance category of 1-2, and the secondary outcome was survival at 6 months.

Results: A total of 1339 patients were treated with TTM in twenty-two emergency departments. Of those, 1054 were treated at 33°C, and 285 were treated at 36°C. There was no significant difference in good neurological outcomes at 6 months (30.6% vs. 31.2%, p = 0.850, adjusted OR 0.97, 95% CI = 0.73-1.29]) and survival at six months (41.4% vs. 38.7%, p = 0.401, adjusted HR 1.08, 95% CI = 0.91-1.28]) between TTM 33°C and TTM 36°C. After propensity score matching, good neurological outcomes at 6 months (OR 0.93, 95% CI = 0.74-1.18) and survival at 6 months (HR 1.05, 95% CI = 0.92-1.21) were still not associated with TTM 33°C and TTM 36°C.

Conclusion: In this study, patients treated with a target temperature of 33°C had similar good neurological outcomes and survival at six months compared with those treated with a target temperature of 36°C.

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Conflict of interest statement

The authors have declared that no competing interests exist.

Figures

Fig 1
Fig 1. Flow-chart for study patients with out-of-hospital cardiac arrest between October 2015 and December 2018.
Fig 2
Fig 2. Temperatures in the study groups until 72 hours after target ROSC.
Values are presented as the mean ±SDs.
Fig 3
Fig 3. Forest plot for subgroup analysis of good neurological outcome and survival after six months from ROSC in patients treated with TTM analyzed with multivariate logistic regression and inverse probability treatment weighting(IPTW).
A = Forest plot for subgroup analysis of good neurologic outcome after six months from ROSC in patients treated with TTM using multivariate analysis. B = Forest plot for subgroup analysis of good neurologic outcome after six months from ROSC in patients treated with TTM using IPTW. C = Forest plot for subgroup analysis of survival after six months from ROSC in patients treated with TTM using multivariate analysis. D = Forest plot for subgroup analysis of survival after six months from ROSC in patients treated with TTM using multivariate IPTW.
See this image and copyright information in PMC

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