Comparison of outcomes between cardiogenic and non-cardiogenic cardiac arrest patients receiving targeted temperature management: The nationwide TIMECARD multicenter registry
Background and purpose: Targeted temperature management (TTM) has been recommended for post-resuscitation care of cardiac arrest (CA) patients who remain comatose. However, the differences between cardiogenic and non-cardiogenic causes need further investigation. Thus, this study aimed to investigat...
| Main Authors: | , , , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
Elsevier
2023-08-01
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| Series: | Journal of the Formosan Medical Association |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S0929664622004296 |
| _version_ | 1827900904457633792 |
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| author | Mei-Tzu Wang Min-Shan Tsai Chien-Hua Huang Li-Kuo Kuo Hsinhui Hsu Chih-Hung Lai Kun Chang Lin Wei-Chun Huang |
| author_facet | Mei-Tzu Wang Min-Shan Tsai Chien-Hua Huang Li-Kuo Kuo Hsinhui Hsu Chih-Hung Lai Kun Chang Lin Wei-Chun Huang |
| author_sort | Mei-Tzu Wang |
| collection | DOAJ |
| description | Background and purpose: Targeted temperature management (TTM) has been recommended for post-resuscitation care of cardiac arrest (CA) patients who remain comatose. However, the differences between cardiogenic and non-cardiogenic causes need further investigation. Thus, this study aimed to investigate the difference in outcomes between cardiogenic and non-cardiogenic CA patients receiving TTM. Methods: The TIMECARD registry established the study cohort and database for patients receiving TTM between January 2013 and September 2019. A total of 543 patients were enrolled, with 305 and 238 patients in the cardiogenic and non-cardiogenic groups, respectively. Results: Compared with the non-cardiogenic group, the cardiogenic group had higher proportion of initial shockable rhythm, better survival (cardiogenic: 45.9%; non-cardiogenic: 30.7%, P = 0.0017), and better neurologic performance at discharge. In the cardiogenic group, witnessed collapse (OR = 0.31, 95% CI: 0.13–0.72), and coronary intervention (OR = 0.45, 95% CI: 0.24–0.84) were positive predictors for overall outcome. Mean arterial pressure <65 mmHg led to poor outcome regardless in the cardiogenic (OR = 3.31, 95% CI: 1.46–7.52) or non-cardiogenic group (OR = 2.39, 95% CI: 1.06–5.39). Conclusion: Patients with cardiogenic CA post TTM had better survival and neurologic performance at discharge than those without cardiogenic CA. Cardiogenic etiology was a potential predictor of better cardiac arrest survival, but it was not an independent risk factor for overall outcome after adjusting for potential covariates. In the cardiogenic group, better outcomes were reported in patients with witnessed collapse, bystander cardiopulmonary resuscitation, as well as those receiving coronary intervention. |
| first_indexed | 2024-03-12T23:38:59Z |
| format | Article |
| id | doaj.art-ab7299b799fc4396b8468d9f288c5c11 |
| institution | Directory Open Access Journal |
| issn | 0929-6646 |
| language | English |
| last_indexed | 2024-03-12T23:38:59Z |
| publishDate | 2023-08-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Journal of the Formosan Medical Association |
| spelling | doaj.art-ab7299b799fc4396b8468d9f288c5c112023-07-15T04:28:11ZengElsevierJournal of the Formosan Medical Association0929-66462023-08-011228675689Comparison of outcomes between cardiogenic and non-cardiogenic cardiac arrest patients receiving targeted temperature management: The nationwide TIMECARD multicenter registryMei-Tzu Wang0Min-Shan Tsai1Chien-Hua Huang2Li-Kuo Kuo3Hsinhui Hsu4Chih-Hung Lai5Kun Chang Lin6Wei-Chun Huang7Department of Critical Care Medicine, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan; Section of Cardiology, Department of Internal Medicine, Kaohsiung Veterans General Hospital, Kaohsiung, TaiwanDepartment of Emergency Medicine, National Taiwan University Medical College and Hospital, Taipei, TaiwanDepartment of Emergency Medicine, National Taiwan University Medical College and Hospital, Taipei, TaiwanDepartment of Critical Care Medicine, MacKay Memorial Hospital, Taipei branch, Taiwan; Department of Medicine, Mackay Medical College, New Taipei City, TaiwanDepartment of Critical Care Medicine, Changhua Christian Hospital, TaiwanCardiovascular Center, Taichung Veterans General Hospital, Taichung, Taiwan; Institute of Clinical Medicine, National Yang-Ming University, Taipei, TaiwanDepartment of Critical Care Medicine, Kaohsiung Veterans General Hospital, Kaohsiung, TaiwanDepartment of Critical Care Medicine, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan; School of Medicine, National Yang-Ming University, Taipei, Taiwan; Department of Physical Therapy, Fooyin University, Kaohsiung, Taiwan; Corresponding author. Department of Critical Care Medicine, Kaohsiung Veterans General Hospital, No. 386, Dazhong 1st Rd., Zuoying Dist., Kaohsiung City 813, Taiwan.Background and purpose: Targeted temperature management (TTM) has been recommended for post-resuscitation care of cardiac arrest (CA) patients who remain comatose. However, the differences between cardiogenic and non-cardiogenic causes need further investigation. Thus, this study aimed to investigate the difference in outcomes between cardiogenic and non-cardiogenic CA patients receiving TTM. Methods: The TIMECARD registry established the study cohort and database for patients receiving TTM between January 2013 and September 2019. A total of 543 patients were enrolled, with 305 and 238 patients in the cardiogenic and non-cardiogenic groups, respectively. Results: Compared with the non-cardiogenic group, the cardiogenic group had higher proportion of initial shockable rhythm, better survival (cardiogenic: 45.9%; non-cardiogenic: 30.7%, P = 0.0017), and better neurologic performance at discharge. In the cardiogenic group, witnessed collapse (OR = 0.31, 95% CI: 0.13–0.72), and coronary intervention (OR = 0.45, 95% CI: 0.24–0.84) were positive predictors for overall outcome. Mean arterial pressure <65 mmHg led to poor outcome regardless in the cardiogenic (OR = 3.31, 95% CI: 1.46–7.52) or non-cardiogenic group (OR = 2.39, 95% CI: 1.06–5.39). Conclusion: Patients with cardiogenic CA post TTM had better survival and neurologic performance at discharge than those without cardiogenic CA. Cardiogenic etiology was a potential predictor of better cardiac arrest survival, but it was not an independent risk factor for overall outcome after adjusting for potential covariates. In the cardiogenic group, better outcomes were reported in patients with witnessed collapse, bystander cardiopulmonary resuscitation, as well as those receiving coronary intervention.http://www.sciencedirect.com/science/article/pii/S0929664622004296Cardiopulmonary resuscitationCoronary interventionDefibrillatorsHeart arrestHypothermiaInduced |
| spellingShingle | Mei-Tzu Wang Min-Shan Tsai Chien-Hua Huang Li-Kuo Kuo Hsinhui Hsu Chih-Hung Lai Kun Chang Lin Wei-Chun Huang Comparison of outcomes between cardiogenic and non-cardiogenic cardiac arrest patients receiving targeted temperature management: The nationwide TIMECARD multicenter registry Journal of the Formosan Medical Association Cardiopulmonary resuscitation Coronary intervention Defibrillators Heart arrest Hypothermia Induced |
| title | Comparison of outcomes between cardiogenic and non-cardiogenic cardiac arrest patients receiving targeted temperature management: The nationwide TIMECARD multicenter registry |
| title_full | Comparison of outcomes between cardiogenic and non-cardiogenic cardiac arrest patients receiving targeted temperature management: The nationwide TIMECARD multicenter registry |
| title_fullStr | Comparison of outcomes between cardiogenic and non-cardiogenic cardiac arrest patients receiving targeted temperature management: The nationwide TIMECARD multicenter registry |
| title_full_unstemmed | Comparison of outcomes between cardiogenic and non-cardiogenic cardiac arrest patients receiving targeted temperature management: The nationwide TIMECARD multicenter registry |
| title_short | Comparison of outcomes between cardiogenic and non-cardiogenic cardiac arrest patients receiving targeted temperature management: The nationwide TIMECARD multicenter registry |
| title_sort | comparison of outcomes between cardiogenic and non cardiogenic cardiac arrest patients receiving targeted temperature management the nationwide timecard multicenter registry |
| topic | Cardiopulmonary resuscitation Coronary intervention Defibrillators Heart arrest Hypothermia Induced |
| url | http://www.sciencedirect.com/science/article/pii/S0929664622004296 |
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