The American journal of emergency medicine · 2024
Cardiac arrest secondary to environmental hypothermia: Incidence and outcomes in an urban emergency department in the Upper Midwestern United States.
СтатьяНазвание и аннотация: Перевод в очереди
Обработка статьи · этапы, ошибки и управление
Загрузка состояния…
Ошибки и ограничения
История · было → стало
Состояние обновляется каждые 5 секунд, пока блок открыт. Процент показывается только там, где известен объём работы. Пауза останавливает продолжение этапа; текущий запрос к источнику может завершиться.
Rischall Megan L, Prekker Matthew E, Knack Sarah K S, Geraci Carolyn, Thor Honoree, Harvey Lauren, Puskarich Michael A
Аннотация
OBJECTIVES: Data describing hypothermic cardiac arrest (HCA) outcomes predominantly originate from patients involved in wilderness accidents. We describe the incidence and outcomes of HCA in an urban environment, with a subgroup analysis of patients with witnessed HCA in the prehospital or emergency department (ED) setting.
METHODS: We completed a retrospective, single center cohort analysis of consecutive adult patients with environmental exposure and core body temperature ≤ 32 °C. We describe characteristics of this cohort and evaluate the relationship between initial core temperature and occurrence of HCA.
RESULTS: 171 patients met eligibility criteria from January 2007 to September 2023. 43 (25 %) sustained HCA, including 6/98 (6 %) of those with moderate hypothermia (28.01-32 °C), 21/55 (38 %) with severe hypothermia (24-28 °C) and 16/18 (89 %) with profound hypothermia (<24 °C). Risk of HCA increases 2.06 times (95 % CI 1.66 to 2.69) for each 1 °C decrease in initial core temperature below 32 °C. Among HCA patients, 18/43 (42 %) had a witnessed HCA during prehospital (n = 8) or ED (n = 10) care. The overall survival rate of HCA was 53 % but was higher in patients with initial core temperature < 28 °C versus those >28C (62 % vs 0 %). Survival of hypothermic patients who experienced their first HCA after arrival in the ED approached that of hypothermic patients without HCA (90 % vs 94 %).
CONCLUSION: Patients with severe hypothermia secondary to environmental exposure in an urban environment are at high-risk of HCA. Witnessed HCA accounts for a significant portion of HCA patients, and patients with witnessed HCA in an ED setting can achieve excellent outcomes.
METHODS: We completed a retrospective, single center cohort analysis of consecutive adult patients with environmental exposure and core body temperature ≤ 32 °C. We describe characteristics of this cohort and evaluate the relationship between initial core temperature and occurrence of HCA.
RESULTS: 171 patients met eligibility criteria from January 2007 to September 2023. 43 (25 %) sustained HCA, including 6/98 (6 %) of those with moderate hypothermia (28.01-32 °C), 21/55 (38 %) with severe hypothermia (24-28 °C) and 16/18 (89 %) with profound hypothermia (<24 °C). Risk of HCA increases 2.06 times (95 % CI 1.66 to 2.69) for each 1 °C decrease in initial core temperature below 32 °C. Among HCA patients, 18/43 (42 %) had a witnessed HCA during prehospital (n = 8) or ED (n = 10) care. The overall survival rate of HCA was 53 % but was higher in patients with initial core temperature < 28 °C versus those >28C (62 % vs 0 %). Survival of hypothermic patients who experienced their first HCA after arrival in the ED approached that of hypothermic patients without HCA (90 % vs 94 %).
CONCLUSION: Patients with severe hypothermia secondary to environmental exposure in an urban environment are at high-risk of HCA. Witnessed HCA accounts for a significant portion of HCA patients, and patients with witnessed HCA in an ED setting can achieve excellent outcomes.