The role of accidental hypothermia in drowning patients with out-of-hospital cardiac arrest: A nationwide registry-based cohort study
Abstract
AIM
This study aimed to investigate the associations between hypothermia and mortality or poor neurological outcome in a nationwide cohort of drowning patients with out-of-hospital cardiac arrest (OHCA).
METHODS
This nationwide, registry-based cohort study reported in-hospital data on drowning patients with OHCA following the Utstein Style For Drowning. Drowning patients with OHCA were identified in the Danish Cardiac Arrest Registry from 2016 to 2021. The primary outcome was the rate of mortality or poor neurological outcome (corresponding to a modified Rankin Scale [mRS] score>3) at 180 days after the drowning incident in patients with OHCA and accidental hypothermia (<35°C) vs normothermia (≥35°C).
RESULTS
This study identified 118 drowning patients with OHCA and found an increased rate of mRS>3 at 180 days after the drowning incident in the hypothermic group compared to the normothermic group (74% vs 18%, p<0.001). The 180-day mortality (mRS=6) was 69% in the hypothermic group compared to 16% in the normothermic group (p<0.001). The hypothermic group had higher rates of ongoing CPR at hospital admission (45% vs 7%, p<0.001), intensive care unit admission (70% vs 41%, p=0.003), and mechanical ventilation during hospitalisation (78% vs 32%, p<0.001) compared to the normothermic group.
CONCLUSION
Hypothermic drowning patients with OHCA had a higher risk of mortality or poor neurological outcome at 180 days compared to normothermic drowning patients with OHCA. This…
How strong is the evidence?
Evidence Hub reads this as a cohort study, done in people. Its evidence level is 3 of 5 (Moderate · trial / cohort / secondary analysis). Trials without a large randomized design, cohorts and secondary analyses give moderate evidence. Reported size: 118 participants or records.
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