Tailoring Targeted Temperature Management in Comatose Out-of-Hospital Cardiac Arrest Survivors: A Retrospective Analysis Based on the rCAST Score Classification
Abstract
:1. Introduction
2. Materials and Methods
2.1. Study Design and Population
2.2. Data Collection
2.3. Statistical Analysis
3. Results
4. Discussion
5. Conclusions
Supplementary Materials
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
References
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Characteristics | Total (n = 300) | Low (n = 28) | Moderate (n = 144) | High (n = 128) | p-Value |
---|---|---|---|---|---|
Age, years | 65.5 (51.5–74.00) | 64.5 (56.0–72.5) | 66.0 (52.0–74.0) | 65.5 (50.0–75.0) | 0.829 |
Male | 209 (69.7) | 21 (75.0) | 96 (66.7) | 92 (71.9) | 0.526 |
Arrest etiology, trauma | 26 (8.7) | 0 (0.0) | 9 (6.3) | 17 (13.3) | 0.028 * |
Witnessed | 225 (75.0) | 24 (85.7) | 117 (81.3) | 84 (65.6) | 0.005 * |
Bystander CPR | 209 (69.7) | 20 (71.4) | 101 (70.1) | 88 (68.8) | 0.948 |
Shockable rhythm | 100 (33.3) | 20 (71.4) | 57 (39.6) | 23 (18.0) | <0.001 * |
Duration of resuscitation, min | 26.5 (13.0–39.0) | 12.0 (6.5–16.5) | 17.5 (10.0–33.0) | 35.5 (27.5–45.5) | <0.001 * |
Past medical history | |||||
Hypertension | 101 (33.7) | 8 (28.6) | 54 (37.5) | 39 (31.0) | 0.432 |
Diabetes mellitus | 86 (28.7) | 7 (25.0) | 41 (28.5) | 38 (30.2) | 0.853 |
Heart disease | 82 (27.3) | 13 (46.4) | 43 (29.9) | 26 (20.6) | 0.015 * |
Stroke | 17 (5.7) | 0 (0.0) | 12 (8.3) | 5 (4.0) | 0.119 |
Serum pH | 7.014 (6.847–7.162) | 7.291 (7.211–7.371) | 7.109 (7.022–7.216) | 6.847 (6.732–6.938) | <0.001 * |
Serum lactate | 10.2 (7.4–14.1) | 6.8 (3.5–9.5) | 8.6 (6.6–12.0) | 13.3 (10.1–15.0) | <0.001 * |
PLR | 133 (44.3) | 23 (82.1) | 85 (59.0) | 25 (19.5) | <0.001 * |
Motor score of GCS | 1 (1–1) | 4 (3–4) | 1 (1–1) | 1 | <0.001 * |
TTM | 204 (68.0) | 25 (89.3) | 93 (64.6) | 86 (67.2) | 0.036 * |
Outcome | |||||
Survival to discharge | 147 (49.0) | 23 (82.1) | 91 (63.2) | 33 (25.8) | <0.001 * |
CPC 1, 2 at discharge | 76 (25.3) | 17 (60.7) | 56 (38.9) | 3 (2.3) | <0.001 * |
Characteristics | Univariate | Multivariate | ||||
---|---|---|---|---|---|---|
OR | 95% CI | p-Value | aOR | 95% CI | p-Value | |
Age, years | 0.98 | 0.97–1.00 | 0.021 * | 0.97 | 0.95–0.99 | 0.010 * |
Male | 1.19 | 0.67–2.12 | 0.553 | |||
Arrest etiology, trauma | 0.51 | 0.17–1.53 | 0.222 | |||
Witnessed | 1.86 | 0.95–3.61 | 0.066 | |||
Bystander CPR | 1.09 | 0.62–1.93 | 0.761 | |||
Duration of resuscitation, min | 0.92 | 0.90–0.95 | <0.001 * | 0.95 | 0.92–0.98 | <0.001 * |
Past medical history | ||||||
Hypertension | 1.02 | 0.59–1.77 | 0.946 | |||
Diabetes mellitus | 0.64 | 0.35–1.18 | 0.148 | |||
Heart disease | 1.20 | 0.68–2.13 | 0.535 | |||
Stroke | 0.89 | 0.28–2.83 | 0.848 | |||
PLR | 15.44 | 7.50–31.90 | <0.001 * | 6.74 | 2.96–15.36 | <0.001 * |
rCAST | ||||||
Low | 64.39 | 16.31–254.29 | <0.001 * | 13.86 | 3.82–50.25 | <0.001 * |
Moderate | 26.52 | 8.04–87.43 | <0.001 * | 13.73 | 2.99–63.08 | 0.001 * |
High | Reference | <0.001 * | Reference | <0.001 * | ||
TTM | 2.56 | 1.35–4.85 | 0.003 * | 3.51 | 1.51–8.15 | 0.003 * |
Dataset | Variable | Good Neurological Outcomes at Discharge | ||
---|---|---|---|---|
OR | 95% CI | p-Value | ||
Crude | Non-TTM | Reference | ||
TTM | 2.18 | 1.04–4.55 | 0.039 * | |
IPTW | Non-TTM | Reference | ||
TTM | 2.31 | 1.09–4.91 | 0.029 * |
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Kwon, H.; Park, H.; Kim, D.; Kim, S.-M.; Kim, J.-S.; Kim, Y.-J.; Kim, W.Y. Tailoring Targeted Temperature Management in Comatose Out-of-Hospital Cardiac Arrest Survivors: A Retrospective Analysis Based on the rCAST Score Classification. J. Clin. Med. 2025, 14, 3931. https://doi.org/10.3390/jcm14113931
Kwon H, Park H, Kim D, Kim S-M, Kim J-S, Kim Y-J, Kim WY. Tailoring Targeted Temperature Management in Comatose Out-of-Hospital Cardiac Arrest Survivors: A Retrospective Analysis Based on the rCAST Score Classification. Journal of Clinical Medicine. 2025; 14(11):3931. https://doi.org/10.3390/jcm14113931
Chicago/Turabian StyleKwon, Hyojeong, Hanna Park, Dongju Kim, Sang-Min Kim, June-Sung Kim, Youn-Jung Kim, and Won Young Kim. 2025. "Tailoring Targeted Temperature Management in Comatose Out-of-Hospital Cardiac Arrest Survivors: A Retrospective Analysis Based on the rCAST Score Classification" Journal of Clinical Medicine 14, no. 11: 3931. https://doi.org/10.3390/jcm14113931
APA StyleKwon, H., Park, H., Kim, D., Kim, S.-M., Kim, J.-S., Kim, Y.-J., & Kim, W. Y. (2025). Tailoring Targeted Temperature Management in Comatose Out-of-Hospital Cardiac Arrest Survivors: A Retrospective Analysis Based on the rCAST Score Classification. Journal of Clinical Medicine, 14(11), 3931. https://doi.org/10.3390/jcm14113931