Factors Predicting Bacterial Infection in Out-of-Hospital Cardiac Arrest Patients Undergoing Targeted Temperature Management.

Abstract

The objective of this study was to determine a risk factor for predicting bacterial infection in patients, who survived out-of-hospital cardiac arrest (OHCA), during targeted temperature management (TTM). This prospective registry-based retrospective observational study was conducted from November 2010 to October 2017. We measured several biomarkers such as whole blood cell counts, and levels of C-reactive protein and procalcitonin daily during TTM. The primary outcome was bacterial growth in initial blood or sputum cultures. A total of 116 patients were analyzed in this study. The bacterial growth rate was 32.8% and the procalcitonin levels measured at 24 h from cardiac arrest was significantly higher in the culture-positive group than the culture-negative group (10.6 vs. 2.5 ng/mL, p = 0.017). Area under the receiver operating characteristic curve for procalcitonin obtained after 24 h was 0.727 and the cutoff value was 6.5 ng/mL (odds ratio 9.58 [95% confidential interval, CI 2.21-41.55], p = 0.003). Sensitivity was 71.4% [95% CI 41.9-91.6] and specificity was 79.3% [95% CI 60.3-92.0]. Procalcitonin measured at 24 h from cardiac arrest was associated with bacterial infection in OHCA patients undergoing TTM. Further prospective interventional studies are needed to validate these results.