Hypothermic treatment improved survival for young cardiac arrest patients

Issue: June 2013

Younger age is an independent predictor of survival for patients undergoing hypothermia treatment after cardiac arrest, researchers reported at the Society for Cardiovascular Angiography and Interventions 2013 Scientific Sessions.

Perspective from Barry M. Cohen, MD

“When you look at national survival rates [after cardiac arrest], the statistics are very dismal. We believe that, especially in younger patients, if you treat aggressively with hypothermia early on, it can significantly improve survival,” Suhail Allaqaband, MD, FSCAI, clinical adjunct professor of cardiology and associate program director of interventional cardiology fellowship for Aurora Health Care, Milwaukee, said in a press release.

Researchers examined age-based differences and predictors of survival with use of hypothermia after cardiac arrest in 179 patients. All were treated by standardized hypothermia after cardiac arrest protocol at a tertiary care center from January 2008 to May 2012.

Survival rates for patients aged younger than 65 years (n=97) increased by 43%. Survival for older patients (n=82) was improved by 29%, according to results from Allaqaband, Anushree Agarwal, MD, clinical cardiology fellow, and colleagues.

The discharge rate following treatment was better for younger patients, with 71% able to go home without maintaining significant injury compared with 36% of older patients.

Suhail Allaqaband

“Patients who were treated with hypothermia had a better chance of being released from the hospital without suffering from extensive neurological damage or slipping into a vegetative state,” Allaqaband said.

Patients who underwent emergency cardiac catheterization also had better odds of survival. According to the researchers, urgent cardiac catheterization was an independent predictor of survival in older patients.

Substance abuse was the primary cause of cardiac arrest in 38% of the younger patients in this study.

In other results, younger patients were less likely to have hypertension (42% vs. 58%), CAD (22% vs. 54%), cardiomyopathy (14% vs. 32%), renal failure (18% vs. 40%), stroke (3% vs. 12%), cardiac cause for arrest (54% vs. 72%), hypotension during hypothermia (31% vs. 51%) and bradycardia during hypothermia (25% vs. 43%) compared with older patients.

For more information:

Agarwal A. Poster C-033. Presented at: the Society for Cardiovascular Angiography and Interventions Scientific Sessions; May 8-11, 2013; Orlando, Fla.

Disclosure: Agarwal and Allaqaband report no relevant financial disclosures.

Perspective

Barry M. Cohen, MD

Hypothermia is the standard of care in cardiac arrest patients with the goal of improving neurological outcomes and enhancing survival. Drs. Agarwal and Allaqaband reported increased survival rates by 43% in younger patients (<65 years) and by 29% in older patients. Nearly twice as many younger patients — 71% as compared with 36% of older patients — went home without sustaining significant injury. Patients undergoing cardiac catheterization had better outcomes.

I am greatly encouraged to see these outcomes. I can remember my trepidation when we instituted systemic hypothermia on a 38-year-old woman post-arrest in 2008, which ultimately resulted in a total recovery.

Barry M. Cohen, MD

Medical Director, Cardiac Catheterization Lab

Morristown Medical Center, Morristown, N.J.

Disclosures: Cohen reports no relevant financial disclosures.