Abstract
BACKGROUND: Despite the established concordance between core temperature and brain temperature (BT) in out-of-hospital cardiac arrest (OHCA) patients, the relationship between BT and neurological outcomes in those who received targeted temperature management (TTM) has yet to be elucidated. Thus, this study aimed to explore the relationship between BT and neurological outcome in OHCA patients who received TTM. METHODS: This observational study involved adult patients (≥18 years) with OHCA who received TTM at 33 °C between April 2021 and December 2023. We recorded BTs at the initiation of TTM (BT(INI)) and during the maintenance phase of TTM (BT(MAIN)). A neurological outcome at 6 months was the primary outcome. Poor outcome was considered as Cerebral Performance Categories 3, 4, and 5. RESULTS: Of the 149 included patients with OHCA, 109 (73.2%) patients exhibited poor outcomes. Compared with the good outcome group, the BT(INI) (35.8 °C [interquartile range (IQR), 33.4-36.3 °C] vs. 33.4°C [IQR, 32.6-35.4 °C]) and BT(MAIN) (33.1 °C [IQR, 32.8-33.2 °C] vs. 32.6 °C [IQR, 32.2-32.9 °C]) were lower in the poor outcome group. Multivariate analysis after adjusting for confounders revealed that BT(INI) (odds ratio (OR), 0.223; 95% confidence interval (CI), 0.054-0.917; p = 0.038) and BT(MAIN) (OR, 0.078; 95% CI, 0.019-0.322; p < 0.001) were associated with poor outcomes. CONCLUSIONS: BTs at the initiation of TTM and during the maintenance phase of TTM at 33 °C are associated with poor outcomes.