Abstract 17768: Effect of Time Interval From Return of Spontaneous Circulation to the Target Temperature Management on Good Neurological Outcomes in Out-of-Hospital Cardiac Arrest: A Nationwide Observational Study

Objectives: The target temperature management (TTM) has been known to be associated with better neurological recovery in out-of-hospital cardiac arrest (OHCA). However, it is controversial whether the time to initiation of TTM from return of spontaneous circulation (ROSC) is associated with better neurological recovery or not. Methods: This is a nationwide observational and cross-sectional study. The adult (ageu003e= 19 or older) and cardiac OHCA who received TTM within 6 hours after ROSC from 2013 to 2014 in Korea were analyzed, excluding unknown time factor and outcomes. The time to receive TTM (T-TTM) was defined as time intervals from the time at final ROSC and the time to start control the temperature or initiate the hypothermia. The T-TTM was categorized with T-TTM0 ( = 4 hours). Main outcome was define as cerebral performance scale 1 or 2 (Good CPC). We tested the association between T-TTM groups (reference=T-TTM0) and Good CPC using multivariable logistic regression model adjusting for age, gender, witness, bystander CPR, location, primary ECG, ambulance response time interval, and level of emergency department. Results: From 54662 OHCAs of study periods, 895 cases were analyzed. The Good CPCs were 31.2% for all patients, 26.3%, 32.1%, 32.1%, 34.7%, and 30.1% for T-TTM0, T-TTM1, T-TTM2, T-TTM3, T-TTM4, and T-TTM5, respectively. (p=0.652) The adjusted odds ratios (95% confidence intervals) were 0.755(0.388-1.467), 0.759(0.397 1.448), 0.869(0.418-1.807), and 0.773(0.394-1.518), respectively. Conclusion: The difference in effect according to elapsed time intervals to start TTM after ROSC in adult cardiac OHCA was not significant in a nationwide observational study.