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APACHE II Score Immediately after Cardiac Arrest as a Predictor of Good Neurological Outcome in Out-of-Hospital Cardiac Arrest Patients Receiving Targeted Temperature Management

BACKGROUND: This study assessed the association between the initial Acute Physiology and Chronic Health Evaluation (APACHE) II score and good neurological outcome in comatose survivors of out-of-hospital cardiac arrest who received targeted temperature management (TTM). METHODS: Data from survivors...

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Autores principales: Kim, Sang-Il, Kim, Youn-Jung, Lee, You-Jin, Ryoo, Seung Mok, Sohn, Chang Hwan, Seo, Dong Woo, Lee, Yoon-Seon, Lee, Jae Ho, Lim, Kyoung Soo, Kim, Won Young
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Korean Society of Critical Care Medicine 2018
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6849058/
https://www.ncbi.nlm.nih.gov/pubmed/31723867
http://dx.doi.org/10.4266/acc.2017.00514
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author Kim, Sang-Il
Kim, Youn-Jung
Lee, You-Jin
Ryoo, Seung Mok
Sohn, Chang Hwan
Seo, Dong Woo
Lee, Yoon-Seon
Lee, Jae Ho
Lim, Kyoung Soo
Kim, Won Young
author_facet Kim, Sang-Il
Kim, Youn-Jung
Lee, You-Jin
Ryoo, Seung Mok
Sohn, Chang Hwan
Seo, Dong Woo
Lee, Yoon-Seon
Lee, Jae Ho
Lim, Kyoung Soo
Kim, Won Young
author_sort Kim, Sang-Il
collection PubMed
description BACKGROUND: This study assessed the association between the initial Acute Physiology and Chronic Health Evaluation (APACHE) II score and good neurological outcome in comatose survivors of out-of-hospital cardiac arrest who received targeted temperature management (TTM). METHODS: Data from survivors of cardiac arrest who received TTM between January 2011 and June 2016 were retrospectively analyzed. The initial APACHE II score was determined using the data immediately collected after return of spontaneous circulation rather than within 24 hours after being admitted to the intensive care unit. Good neurological outcome, defined as Cerebral Performance Category 1 or 2 on day 28, was the primary outcome of this study. RESULTS: Among 143 survivors of cardiac arrest who received TTM, 62 (43.4%) survived, and 34 (23.8%) exhibited good neurological outcome on day 28. The initial APACHE II score was significantly lower in the patients with good neurological outcome than in those with poor neurological outcome (23.71 ± 4.39 vs. 27.62 ± 6.16, P = 0.001). The predictive ability of the initial APACHE II score for good neurological outcome, assessed using the area under the receiver operating characteristic curve, was 0.697 (95% confidence interval [CI], 0.599 to 0.795; P = 0.001). The initial APACHE II score was associated with good neurological outcome after adjusting for confounders (odds ratio, 0.878; 95% CI, 0.792 to 0.974; P = 0.014). CONCLUSIONS: In the present study, the APACHE II score calculated in the immediate post-cardiac arrest period was associated with good neurological outcome. The initial APACHE II score might be useful for early identification of good neurological outcome.
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spelling pubmed-68490582019-11-13 APACHE II Score Immediately after Cardiac Arrest as a Predictor of Good Neurological Outcome in Out-of-Hospital Cardiac Arrest Patients Receiving Targeted Temperature Management Kim, Sang-Il Kim, Youn-Jung Lee, You-Jin Ryoo, Seung Mok Sohn, Chang Hwan Seo, Dong Woo Lee, Yoon-Seon Lee, Jae Ho Lim, Kyoung Soo Kim, Won Young Acute Crit Care Original Article BACKGROUND: This study assessed the association between the initial Acute Physiology and Chronic Health Evaluation (APACHE) II score and good neurological outcome in comatose survivors of out-of-hospital cardiac arrest who received targeted temperature management (TTM). METHODS: Data from survivors of cardiac arrest who received TTM between January 2011 and June 2016 were retrospectively analyzed. The initial APACHE II score was determined using the data immediately collected after return of spontaneous circulation rather than within 24 hours after being admitted to the intensive care unit. Good neurological outcome, defined as Cerebral Performance Category 1 or 2 on day 28, was the primary outcome of this study. RESULTS: Among 143 survivors of cardiac arrest who received TTM, 62 (43.4%) survived, and 34 (23.8%) exhibited good neurological outcome on day 28. The initial APACHE II score was significantly lower in the patients with good neurological outcome than in those with poor neurological outcome (23.71 ± 4.39 vs. 27.62 ± 6.16, P = 0.001). The predictive ability of the initial APACHE II score for good neurological outcome, assessed using the area under the receiver operating characteristic curve, was 0.697 (95% confidence interval [CI], 0.599 to 0.795; P = 0.001). The initial APACHE II score was associated with good neurological outcome after adjusting for confounders (odds ratio, 0.878; 95% CI, 0.792 to 0.974; P = 0.014). CONCLUSIONS: In the present study, the APACHE II score calculated in the immediate post-cardiac arrest period was associated with good neurological outcome. The initial APACHE II score might be useful for early identification of good neurological outcome. Korean Society of Critical Care Medicine 2018-05 2018-05-31 /pmc/articles/PMC6849058/ /pubmed/31723867 http://dx.doi.org/10.4266/acc.2017.00514 Text en Copyright © 2018 The Korean Society of Critical Care Medicine This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Original Article
Kim, Sang-Il
Kim, Youn-Jung
Lee, You-Jin
Ryoo, Seung Mok
Sohn, Chang Hwan
Seo, Dong Woo
Lee, Yoon-Seon
Lee, Jae Ho
Lim, Kyoung Soo
Kim, Won Young
APACHE II Score Immediately after Cardiac Arrest as a Predictor of Good Neurological Outcome in Out-of-Hospital Cardiac Arrest Patients Receiving Targeted Temperature Management
title APACHE II Score Immediately after Cardiac Arrest as a Predictor of Good Neurological Outcome in Out-of-Hospital Cardiac Arrest Patients Receiving Targeted Temperature Management
title_full APACHE II Score Immediately after Cardiac Arrest as a Predictor of Good Neurological Outcome in Out-of-Hospital Cardiac Arrest Patients Receiving Targeted Temperature Management
title_fullStr APACHE II Score Immediately after Cardiac Arrest as a Predictor of Good Neurological Outcome in Out-of-Hospital Cardiac Arrest Patients Receiving Targeted Temperature Management
title_full_unstemmed APACHE II Score Immediately after Cardiac Arrest as a Predictor of Good Neurological Outcome in Out-of-Hospital Cardiac Arrest Patients Receiving Targeted Temperature Management
title_short APACHE II Score Immediately after Cardiac Arrest as a Predictor of Good Neurological Outcome in Out-of-Hospital Cardiac Arrest Patients Receiving Targeted Temperature Management
title_sort apache ii score immediately after cardiac arrest as a predictor of good neurological outcome in out-of-hospital cardiac arrest patients receiving targeted temperature management
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6849058/
https://www.ncbi.nlm.nih.gov/pubmed/31723867
http://dx.doi.org/10.4266/acc.2017.00514
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