Hospital mode of death in therapeutic hypothermia-treated out-of-hospital cardiac arrest patients = Hospital mode of death in therapeutic hypothermia-treated out-of-hospital cardiac arrest patients

다국어 초록 (Multilingual Abstract)

Introduction: To determine the hospital mode of death in patients with therapeutic hypothermia (TH) after out-of-hospital cardiac arrest (OHCA) in South Korea where the withdrawal of life-sustaining treatment (WLST) is not applied to the patients due to cultural factors. Material & Methods: We performed a retrospective analysis of a multicenter registry including adult OHCA patients treated with TH in 24 hospitals from 2007 to 2012. The registry data and electronic medical records of the individual patients were carefully reviewed and categorized as brain injury, cardiovascular disorder or others.Descriptive analysis and comparison of time to death between the 3 categories were performed. Results: Among 930 patients included in the registry, 680 (73%) exhibited poor neurological outcome [CPC 3=55 (5.9%), CPC 4=251 (27.0%), and CPC 5=374 (40.2%)]. Among 373 patients with identified cause of death, 73 (19.6%) died due to cardiovascular disorder; 98 (26.3%) due to brain injury; and 202 (54.2%) due to other causes. Death due to cardiovascular disorder occurred significantly earlier (2 [1-2] days) than brain injury (5.5 [3-12] days, p<.001) and other causes (5.5 [3-14] days, p<.001). Conclusion: In our study including adult TH-treated OHCA patients who WLST were not applied, death due to brain injury was relatively low, whereas other causes, mainly multiple organ failure, were main cause of death.