Table 3.
Adverse events and concomitant treatments with corresponding odds ratios for poor neurological outcomes at the time of hospital discharge
| Category | AEs and concomitant treatments | Total N (%) | CPC 1 and 2 n (%) | CPC 3–5 n (%) | OR (95 % CI) | p | Adjusted OR (95 % CI) | p |
|---|---|---|---|---|---|---|---|---|
| 704 (100) | 228(32.4) | 476 (67.6) | ||||||
| Cooling -related AEs | Overcoolinga | 128 (18.2) | 23 (10.1) | 105 (22.1) | 2.52 (1.56–4.09) | <.001 | 1.16 (0.58–2.31) | 0.681 |
| Bradycardiab | 83 (11.8) | 35 (15.4) | 48 (10.1) | 0.62 (0.39–0.99) | 0.044 | 0.75 (0.37–1.53) | 0.429 | |
| Tachyarrhythmia | 67 (9.5) | 24 (10.5) | 43 (9.0) | 0.84 (0.50–1.43) | 0.528 | 0.72 (0.33–1.55) | 0.398 | |
| Hypokalemiac | 220 (31.3) | 65 (28.5) | 155 (32.6) | 1.21 (0.86–1.71) | 0.278 | 1.21 (0.71–2.04) | 0.486 | |
| Hyperglycemiad | 321 (45.6) | 81 (35.5) | 240 (50.4) | 1.85 (1.33–2.56) | <.001 | 1.37 (0.84–2.24) | 0.210 | |
| Bleeding | 21 (3.0) | 6 (2.6) | 15 (3.2) | 1.20 (0.46–3.15) | 0.705 | 0.89 (0.21–3.71) | 0.872 | |
| Hypotensione | 204 (29.0) | 54 (23.7) | 150 (31.5) | 1.48 (1.03–2.13) | 0.033 | 1.03 (0.59–1.79) | 0.926 | |
| Rewarming -related AEs | Rebound hyperthermiaf | 85 (12.1) | 29 (12.7) | 56 (11.8) | 0.92 (0.57–1.48) | 0.716 | 1.33 (0.61–2.92) | 0.473 |
| Arrhythmia | 42 (6.0) | 10 (4.4) | 32 (6.7) | 1.57 (0.76–3.25) | 0.224 | 1.70 (0.61–4.69) | 0.308 | |
| Hyperkalemiag | 48 (6.8) | 7 (3.1) | 41 (8.6) | 2.96 (1.31–6.74) | 0.009 | 1.09 (0.37–3.19) | 0.881 | |
| Hypoglycemiah | 70 (9.9) | 22 (9.7) | 48 (10.7) | 1.05 (0.62–1.79) | 0.858 | 1.14 (0.50–2.57) | 0.762 | |
| Bleeding | 14 (2.0) | 3 (1.3) | 11 (2.3) | 1.77 (0.49–6.41) | 0.383 | 1.05 (0.18–6.06) | 0.956 | |
| Hypotensione | 152 (21.6) | 36 (15.8) | 116 (24.4) | 1.72 (1.14–2.60) | 0.01 | 0.99 (0.54–1.83) | 0.984 | |
| Other AEs during advanced critical care Concomitant treatments | Pneumoniai | 279 (39.6) | 70 (30.7) | 209 (43.9) | 1.77 (1.26–2.47) | <.001 | 1.05 (0.63–1.74) | 0.852 |
| Sepsis | 100 (14.2) | 17 (7.5) | 83 (17.4) | 2.62 (1.52–4.53) | <.001 | 3.12 (1.40–6.97) | 0.005 | |
| Myoclonusj | 154 (21.9) | 34 (14.9) | 120 (25.2) | 1.92 (1.27–2.92) | 0.002 | 3.72 (1.93–7.16) | <.001 | |
| Seizurek | 153 (21.7) | 24 (10.5) | 129 (27.1) | 3.16 (1.98–5.05) | <.001 | 4.02 (2.04–7.91) | <.001 | |
| Hypoglycemial | 162 (23.0) | 36 (15.8) | 126 (26.5) | 1.92 (1.27–2.89) | 0.002 | 2.03 (1.09–3.78) | 0.025 | |
| Anticonvulsants | 287 (40.8) | 71 (31.1) | 216 (45.4) | 1.84 (1.32–2.56) | <.001 | 1.69 (1.03–2.77) | 0.039 | |
| Insulin | 460 (65.3) | 136(59.7) | 324 (68.1) | 1.44 (1.04–2.00) | 0.028 | 0.98 (0.60–1.62) | 0.944 | |
| Analgesics | 323 (45.9) | 122 (53.5) | 201 (42.2) | 0.64 (0.46–0.87) | 0.005 | 0.75 (0.46–1.21) | 0.239 | |
| Sedatives | 657 (93.3) | 222 (97.4) | 435 (91.4) | 0.29 (0.12–0.69) | 0.005 | 0.92 (0.29–2.96) | 0.888 | |
| Neuromuscular blockers | 475 (67.5) | 174 (76.3) | 301 (63.2) | 0.53 (0.37–0.76) | 0.001 | 0.48 (0.28–0.84) | 0.009 |
AEs adverse events, CPC cerebral performance category, OR odds ratio, 95 % CI 95 % confidence interval
a < 32 °C
bHeart rate <40 bpm
c ≤ 3.0 mEq/L
d ≥ 180 mg/Dl
eSBP <90 mmHg or MAP <60 mmHg for at least 30 min or the need for supportive measures (fluid loading and vasopressors or inotropic or both) to maintain a SBP >90 mmHg or MAP >60 mmHg
f > 38 °C within 24 hours of the cessation of cooling
g ≥ 5.0 mEq/L
h ≤ 80 mg/dL
iFour requirements: 1) new or progressive consolidation on the chest radiograph, 2) fever, 3) leukocytosis, and 4) the presence of purulent tracheobronchial secretions
jClinically involuntary movement without epileptiform discharge on EEG
kEither clinically involuntary movement with epileptiform discharge on electroencephalogram (EEG) or epileptiform discharge only on EEG
l ≤ 80 mg/dL within 72 hours after ROSC