Adverse events associated with poor neurological outcome during targeted temperature management and advanced critical care after out-of-hospital cardiac arrest

Kim, Young-Min; Youn, Chun Song; Kim, Soo Hyun; Lee, Byung Kook; Cho, In Soo; Cho, Gyu Chong; Jeung, Kyung Woon; Oh, Sang Hoon; Choi, Seung Pill; Shin, Jong Hwan; Cha, Kyoung-Chul; Oh, Joo Suk; Yim, Hyeon Woo; Park, Kyu Nam

doi:10.1186/s13054-015-0991-9

Critical Care

Table 4 Factors associated with selected adverse events in univariate analyses

From: Adverse events associated with poor neurological outcome during targeted temperature management and advanced critical care after out-of-hospital cardiac arrest

Adverse event	Factors	OR	(95 % CI)	p
Bleeding	Intra-aortic balloon pump	5.40	(1.47–19.83)	0.011
	Continuous renal replacement therapy	3.13	(1.13–8.65)	0.028
	Cardiogenic shock^a	2.39	(1.09–5.26)	0.031
Pneumonia^b	Ice bag only	3.00	(1.79–5.02)	<.001
	Malignancy	2.68	(1.04–6.90)	0.041
	Neurological disease	2.36	(1.25–4.46)	0.008
	Non-shockable initial rhythm	1.58	(1.14–2.20)	0.006
	No bystander cardiopulmonary resuscitation	1.45	(1.03–2.03)	0.033
	Non-cardiac cause of arrest	1.44	(1.06–1.96)	0.021
	Initial presence of pupillary light reflex	0.57	(0.42–0.78)	<.001
	ST-elevation myocardial infarction	0.55	(0.31–0.98)	0.042
	Coronary angiography	0.51	(0.36–0.73)	<.001
	Angina pectoris	0.49	(0.25–0.95)	0.035
	Percutaneous coronary intervention	0.47	(0.26– 0.82)	0.008
	Initial Glasgow coma scale (≥5)	0.44	(0.27– 0.72)	0.001
Sepsis	Intra-aortic balloon pump	3.71	(1.43–9.67)	0.007
	Ice bag only	2.17	(1.20–3.94)	0.010
	Unwitnessed arrest	2.11	(1.37–3.24)	0.001
	No bystander cardiopulmonary resuscitation	1.78	(1.06–2.99)	0.030
	Cardiogenic shock^a	1.72	(1.10–2.68)	0.017
	Non-cardiac cause of arrest	1.65	(1.08–2.53)	0.021
	Coronary angiography	0.58	(0.35–0.98)	0.040
Myoclonus^c	Ice bag only	2.40	(1.42–4.05)	0.001
	Hydrogel pad	1.58	(1.05–2.38)	0.027
	ST-elevation myocardial infarction	0.36	(0.15–0.85)	0.019
	Cooling garment	0.06	(0.01–0.45)	0.006
Seizure^d	Congestive heart failure	2.68	(1.17–6.17)	0.020
	Non-shockable initial rhythm	1.51	(1.01–2.25)	0.043
	Endovascular cooling	0.64	(0.42–0.97)	0.035
	Coronary angiography	0.54	(0.35–0.83)	0.005
	Initial Glasgow coma scale ≥ 5	0.32	(0.16–0.65)	0.002
Hypoglycemia^e	Continuous renal replacement therapy	2.59	(1.45–4.62)	0.001
	Renal disease	2.53	(1.32–4.84)	0.005
	Non-shockable initial rhythm	2.06	(1.37–3.11)	<.001
	Coronary angiography	0.65	(0.43–0.98)	0.039
	Hydrogel pad	0.55	(0.34–0.88)	0.013
	Percutaneous coronary intervention	0.47	(0.23–0.98)	0.042
	Cooling garment	0.25	(0.09–0.70)	0.008

OR odds ratio, 95 % CI 95 % confidence interval
^aHypotension (SBP <90 mmHg or MAP <60 mmHg for at least 30 min or the need for supportive measures (fluid loading and vasopressors or inotropic or both) to maintain a SBP >90 mmHg or MAP >60 mmHg) and end-organ hypoperfusion (cool extremities)
^bFour requirements: 1) new or progressive consolidation on the chest radiograph, 2) fever, 3) leukocytosis, 4) presence of purulent tracheobronchial secretions
^cClinically involuntary movement without epileptiform discharge on EEG
^dEither clinically involuntary movement with epileptiform discharge on EEG or epileptiform discharge only on EEG
^e ≤ 80 mg/dL within 72 hours after ROSC

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ISSN: 1364-8535

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