Citation

Udekwu P, Vincent R, Petrarca D, Farrell M, Roy S. Ther. Hypothermia Temp. Manag. 2018; ePub(ePub): ePub.

Affiliation

WPP General Surgery/Trauma, WakeMed Health and Hospitals , Raleigh, North Carolina.

Copyright

(Copyright © 2018, Mary Ann Liebert Publishers)

DOI

10.1089/ther.2018.0029

PMID

30376419

Abstract

Favorable neurologic outcomes have been reported in near-hanging (NH) victims treated with therapeutic hypothermia (TH), but variable methods and small samples sizes limit interpretability. This study examines the relationship between clinical predictors, TH, and outcomes in NH patients. A risk profile was created by examining relationships between variables. Categorical predictors were assessed with chi-square tests and continuous variables were assessed with t-tests. Logistic regression was conducted to evaluate the unique effect of TH. Thirty-seven NH patients were treated, 22 with cardiac arrest (CA). Poor outcome was significantly associated with age, Glasgow Coma Scale-Motor (GCS-M), pupillary response, and out-of-hospital CA (OHCA) (p's < 0.02). Patients with poor neurologic outcomes were older (M = 40.2 vs. M = 27.6) and had lower GCS-M scores (M = 1.1 vs. M = 4.1). Poor outcome probability was 76% in patients with GCS-M <3, 100% with nonreactive pupils, and 72.1% with OHCA. TH was associated with a worse outcome overall that was not significant after adjusting for GCS-M. Our study demonstrates no impact of TH on NH outcome when controlling for variables associated with poor outcome and relative certainty of poor outcome with CA, GCS-M 1, and nonreactive pupils. Study findings could assist in decisions on the utilization of TH.

Language: en

Keywords

cardiac arrest; near-hanging; therapeutic hypothermia