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首页> 外文期刊>Critical care : >Spontaneous hypothermia on intensive care unit admission is a predictor of unfavorable neurological outcome in patients after resuscitation: an observational cohort study
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Spontaneous hypothermia on intensive care unit admission is a predictor of unfavorable neurological outcome in patients after resuscitation: an observational cohort study

机译：一项观察性队列研究表明，重症监护病房自发性体温过低是复苏后患者神经系统预后不良的预示因素

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IntroductionA large number of patients resuscitated for primary cardiac arrest arrive in the intensive care unit (ICU) with a body temperature < 35.0°C. The aim of this observational cohort study was to determine the association between ICU admission temperature and neurological outcome in this patient group.MethodsDemographics and parameters influencing neurological outcome were retrieved from the charts of all patients resuscitated for primary cardiac arrest and treated with induced mild hypothermia in our ICU from January 2006 until January 2008. Patients were divided into two groups according to their body temperature on ICU admission: a hypothermia group (< 35.0°C) and a non-hypothermia group (≥35.0°C). Neurological outcome after six months was assessed by means of the Glasgow Outcome Score (GOS), with GOS 1 to 3 defined as unfavorable and GOS 4 to 5 as favorable. A logistic regression model was used to analyze the influence of the different parameters on neurological outcome.ResultsThe data of 105 consecutive patients resuscitated for primary cardiac arrest and treated with induced mild hypothermia were analyzed. Median ICU admission temperature was 35.1°C (interquartile range (IQR) 34.3 to 35.7). After six months, 61% of the patients had an unfavorable outcome (59% died and 2% were severely disabled), whereas 39% had a favorable outcome (moderate disability or good recovery). Among patients with spontaneous hypothermia on ICU admission, the percentage with unfavorable outcome was higher (69% versus 50%, P = 0.05). Logistic regression showed that age, acute physiology and chronic health evaluation (APACHE) II and sequential organ failure assessment (SOFA) scores and spontaneous hypothermia on ICU admission all had an increased odds ratio (OR) for an unfavorable outcome after six months. Spontaneous hypothermia had the strongest association with unfavorable outcome (OR 2.6, 95% CI (confidence interval) 1.1 to 5.9), which became even stronger after adjustment for age, presenting heart rhythm, APACHE II and SOFA scores (OR 3.8, CI 1.3 to 11.0).ConclusionsIn this observational cohort study, spontaneous hypothermia on ICU admission was the strongest predictor of an unfavorable neurological outcome in patients resuscitated for primary cardiac arrest.
机译：简介许多因原发性心脏骤停而复苏的患者进入重症监护病房（ICU），体温<35.0°C。这项观察性队列研究的目的是确定该患者组的ICU入院温度与神经系统结局之间的关系。方法从所有因原发性心脏骤停而复苏并经诱导的亚低温治疗的患者的图表中检索影响神经系统结局的人口统计学和参数。我们从2006年1月至2008年1月在ICU住院。根据入院时的体温将患者分为两组：低温组（<35.0°C）和非低温组（≥35.0°C）。六个月后的神经系统预后通过格拉斯哥结果评分（GOS）进行评估，GOS 1至3定义为不良，GOS 4至5为良好。方法采用逻辑回归模型分析不同参数对神经系统预后的影响。结果分析了105例因原发性心脏骤停而复苏并接受亚低温治疗的患者的数据。 ICU入院温度中位数为35.1°C（四分位间距（IQR）34.3至35.7）。六个月后，有61％的患者预后不良（59％的患者死亡，2％的患者严重残疾），而39％的患者预后良好（中度残疾或恢复良好）。在ICU入院时自发性体温过低的患者中，预后不良的百分比更高（69％比50％，P = 0.05）。 Logistic回归分析显示，入院后6个月，年龄，急性生理和慢性健康评估（APACHE）II和连续器官衰竭评估（SOFA）评分以及自发性体温过低均导致OR值比增加（OR）。自发性体温过低与不良结局密切相关（OR 2.6，95％CI（置信区间）1.1至5.9），在调整了年龄后表现出更强的心律，APACHE II和SOFA评分（OR 3.8，CI 1.3至11.0）结论在这项观察性队列研究中，ICU入院时自发性体温过低是最重要的预测指标，可预示在因原发性心脏骤停而复苏的患者中神经功能不良。

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