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Male gender, initial shockable rhythm tied to favourable neurological outcomes after cardiac arrest

15 Nov 2018

In adult cardiac arrest (CA) patients treated with targeted temperature management (TTM), male sex, bystander cardiopulmonary resuscitation (CPR) and the presence of initial shockable rhythm all correlate with greater chances of favourable neurological outcomes, a recent meta-analysis has shown.

A total of 17 studies were eligible for inclusion in the analysis after searching PubMed, Embase and the Cochrane Library databases. Quality assessment scores ranged from 6–9, suggesting fairness and a good risk of bias.

Pooled analysis showed that initial shockable cardiac rhythm correlated with a significantly higher odds of good neurological outcomes at hospital discharge (odds ratio [OR], 7.63; 95 percent CI, 6.51–8.96; p<0.00001), with no significant heterogeneity of evidence (p=0.73).

Moreover, survivors were significantly more likely than nonsurvivors to have shockable cardiac rhythm as first recorded rhythm (OR, 4.88; 3.18–4.79; p<0.00001).

Similarly, bystander CPR was associated with significantly higher chances of favourable neurological outcomes (OR, 1.44; 1.14-1.82; p=0.003), though significant heterogeneity in evidence was reported (p=0.01).

Participant sex likewise played an important role. Survivors were more likely to be male than female (OR, 1.36; 0.99–1.88; p=0.06), but the results were only of borderline significance. Additionally, male sex was significantly correlated with favourable neurological outcomes at discharge (OR, 1.39; 1.20–1.61; p<0.00001).

The present findings “would help in making individualized decisions concerning patients’ eligibility for starting or continuing TTM,” said researchers.

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