PMID- 31422106
OWN - NLM
STAT- MEDLINE
DCOM- 20200917
LR  - 20200917
IS  - 1873-1570 (Electronic)
IS  - 0300-9572 (Linking)
VI  - 143
DP  - 2019 Oct
TI  - Modulating effects of immediate neuroprognosis on early coronary angiography and 
      targeted temperature management following out-of-hospital cardiac arrest: A 
      retrospective cohort study.
PG  - 42-49
LID - S0300-9572(19)30574-X [pii]
LID - 10.1016/j.resuscitation.2019.08.014 [doi]
AB  - AIM: The simplified cardiac arrest hospital prognosis (sCAHP) score is a 
      validated tool for predicting neurological outcomes after out-of-hospital cardiac 
      arrest (OHCA). We used the sCAHP score to evaluate whether the effects of early 
      coronary angiography (CAG) and targeted temperature management (TTM) for OHCA 
      were modulated by immediate neuroprognosis. METHODS: This was a single-centre 
      retrospective observational study. Consecutive OHCA patients were screened 
      between 2011 and 2017. Multivariate logistic regression analysis and generalised 
      additive models (GAMs) were used to examine the associations between independent 
      variables and outcomes. Early CAG was defined as CAG performed within 24 h after 
      return of spontaneous circulation (ROSC). RESULTS: A total of 412 patients were 
      included in the study, and 94 (22.8%) patients had neurologically intact 
      survival. The GAM plot identified a sCAHP score of 185 as the cut-off point to 
      differentiate high-risk (sCAHP score >==185) from low-risk (sCAHP score <185) 
      patients. Regression models indicated that early CAG was significantly associated 
      with favourable neurological [odds ratio (OR) 4.43, 95% confidence interval (CI) 
      2.28-8.60, p < 0.001] and survival outcomes (OR 3.47, 95% CI 1.93-6.25, 
      p < 0.001), independent of the sCAHP score. Although TTM was associated with 
      favourable neurological outcome only in low-risk patients (OR 2.13, 95% CI 
      1.10-4.13, p = 0.02), TTM was associated with improved survival for all patients 
      (OR 2.66, 95% CI 1.54-4.59, p < 0.001), independent of the sCAHP score. 
      CONCLUSIONS: Early CAG and TTM should be considered for all OHCA patients as 
      suggested by guidelines, irrespective of the immediately predicted neuroprognosis 
      after ROSC.
CI  - Copyright (c) 2019 Elsevier B.V. All rights reserved.
FAU - Wang, Chih-Hung
AU  - Wang CH
AD  - Department of Emergency Medicine, National Taiwan University Hospital, Taipei, 
      Taiwan; Department of Emergency Medicine, College of Medicine, National Taiwan 
      University, Taipei, Taiwan. Electronic address: chhuang5940@ntu.edu.tw.
FAU - Tsai, Min-Shan
AU  - Tsai MS
AD  - Department of Emergency Medicine, National Taiwan University Hospital, Taipei, 
      Taiwan; Department of Emergency Medicine, College of Medicine, National Taiwan 
      University, Taipei, Taiwan.
FAU - Chang, Wei-Tien
AU  - Chang WT
AD  - Department of Emergency Medicine, National Taiwan University Hospital, Taipei, 
      Taiwan; Department of Emergency Medicine, College of Medicine, National Taiwan 
      University, Taipei, Taiwan.
FAU - Yu, Ping-Hsun
AU  - Yu PH
AD  - Department of Emergency Medicine, Taipei Hospital, Ministry of Health and 
      Welfare, New Taipei City, Taiwan.
FAU - Wu, Yen-Wen
AU  - Wu YW
AD  - Departments of Internal Medicine and Nuclear Medicine, National Taiwan University 
      Hospital and National Taiwan University College of Medicine, Taipei, Taiwan; 
      Department of Nuclear Medicine and Cardiology Division of Cardiovascular Medical 
      Center, Far Eastern Memorial Hospital, New Taipei City, Taiwan; National 
      Yang-Ming University School of Medicine, Taipei, Taiwan.
FAU - Huang, Chien-Hua
AU  - Huang CH
AD  - Department of Emergency Medicine, National Taiwan University Hospital, Taipei, 
      Taiwan; Department of Emergency Medicine, College of Medicine, National Taiwan 
      University, Taipei, Taiwan.
FAU - Chen, Wen-Jone
AU  - Chen WJ
AD  - Department of Emergency Medicine, National Taiwan University Hospital, Taipei, 
      Taiwan; Department of Emergency Medicine, College of Medicine, National Taiwan 
      University, Taipei, Taiwan; Division of Cardiology, Department of Internal 
      Medicine, National Taiwan University Hospital and National Taiwan University 
      College of Medicine, Taipei, Taiwan.
LA  - eng
PT  - Journal Article
PT  - Observational Study
PT  - Research Support, Non-U.S. Gov't
DEP - 20190815
PL  - Ireland
TA  - Resuscitation
JT  - Resuscitation
JID - 0332173
SB  - IM
MH  - Cardiopulmonary Resuscitation/*methods
MH  - Coronary Angiography
MH  - Coronary Artery Disease/complications/*diagnosis/surgery
MH  - Follow-Up Studies
MH  - Humans
MH  - Hypothermia, Induced/*methods
MH  - Out-of-Hospital Cardiac Arrest/diagnosis/etiology/*therapy
MH  - Percutaneous Coronary Intervention
MH  - Prognosis
MH  - *Registries
MH  - Retrospective Studies
OTO - NOTNLM
OT  - Coronary angiography
OT  - Coronary intervention
OT  - Neuroprognosis
OT  - Out-of-hospital cardiac arrest
OT  - Percutaneous
OT  - Targeted temperature management
EDAT- 2019/08/20 06:00
MHDA- 2020/09/18 06:00
CRDT- 2019/08/19 06:00
PHST- 2019/05/28 00:00 [received]
PHST- 2019/08/01 00:00 [revised]
PHST- 2019/08/06 00:00 [accepted]
PHST- 2019/08/20 06:00 [pubmed]
PHST- 2020/09/18 06:00 [medline]
PHST- 2019/08/19 06:00 [entrez]
AID - S0300-9572(19)30574-X [pii]
AID - 10.1016/j.resuscitation.2019.08.014 [doi]
PST - ppublish
SO  - Resuscitation. 2019 Oct;143:42-49. doi: 10.1016/j.resuscitation.2019.08.014. Epub 
      2019 Aug 15.