병원 전 심정지 후 자발순환이 회복된 환자에서 치료적 저체온 요법을 시행하는데 있어 치료온도까지 도달하는데 영향을 주는 인자 분석

Abstract

Purpose: The relationship between prognostic factors and outcomes of post-cardiac arrest patients treated with therapeutic hypothermia was analyzed. Methods: We conducted a tertiary center retrospective study of post-cardiac arrest patients treated with therapeutic hypothermia between January 2008 and December 2012. We investigated the association of the following factors with outcomes: BMI, time to ROSC, number of vasoactive drugs, smoking, alcohol, and short time to therapeutic range in hypothermia. Results: A total of 251 patients were enrolled in this study. Large number of vasoactive drugs was a prognostic factor of 3-month mortality (adjusted OR 1.96, 95% CI:1.41-2.71, p<0.001). Obesity (BMI≥25 kg/m2) was not associated with delayed time to therapeutic range in hypothermia. Both univariate and multivariate analysis showed that high initial BT (β(SE)=63.64 (11.53), p<0.001) and a small number of vasoactive drugs (β(SE)=18.66(8.74), p=0.034) were independent predictors of delayed time to therapeutic range in hypothermia. Conclusion: In this study, a small number of vasoactive drugs showed a significant influence on delayed time to therapeutic range in patients receiving therapeutic hypothermia after return of spontaneous circulation after out-of-hospital cardiac arrest.