1137: FACTORS ASSOCIATED WITH FAVORABLE OUTCOMES IN CARDIAC ARREST AND TARGETED TEMPERATURE MANAGEMENT

Abstract

Introduction: While guidelines strongly recommend targeted temperature management (TTM), whether early initiation of TTM or time-to-target temperature (TTT) are associated with better outcomes remains elucidated. To clarify if different target temperatures and shorter TTT are associated with favorable neurologic outcomes and reduced mortality in patients with coma after cardiac arrest undergoing TTM Methods: This is a retrospective observational study at a tertiary care hospital in Honolulu, Hawaii. Those who had an out-of-hospital or in-hospital cardiac arrest (OHCA or IHCA) undergoing TTM from November 1, 2020 to August 31, 2021 were included. Patients were dichotomized by the median time to TTM initiation, time from initiation of TTM to achieve target temperature, and TTT (into early and delayed groups). Results: 86 patients (53 with OHCA and 33 with IHCA), mainly including Asian and Native Hawaiian and Pacific Islanders, were included. In multinominal logistic regression analysis, the difference between the initial temperature to target temperature (Δ-temperature) and shorter TTT were identified as a factor positively associated with survival in the IHCA group. Conclusions: There may be specific groups of patients who are likely to benefit from the prompt initiation of TTM, focusing on Δ-temperature as a variable of interest. Further studies are warranted to identify underlying mechanisms associated with the results and response to TTM in different races/ethnicities.