CRP Cardiology Research and Practice 2090-0597 2090-8016 Hindawi Publishing Corporation 10.1155/2016/8798261 8798261 Research Article Renal Insufficiency and Early Bystander CPR Predict In-Hospital Outcomes in Cardiac Arrest Patients Undergoing Mild Therapeutic Hypothermia and Cardiac Catheterization: Return of Spontaneous Circulation, Cooling, and Catheterization Registry (ROSCCC Registry) Chelvanathan Anjala anj33c@hotmail.com 1 Allen David david.allen.w@gmail.com 1 Bews Hilary bewsh@myumanitoba.ca 2 Ducas John jducas@sbgh.mb.ca 1 Minhas Kunal kminhas@sbgh.mb.ca 1 Vo Minh mvo@sbgh.mb.ca 1 Kass Malek mkass@sbgh.mb.ca 1 Ravandi Amir aravandi@sbrc.ca 1,2 2 Tam James W. jtam@sbgh.mb.ca 1 Jassal Davinder S. djassal@sbgh.mb.ca 1,2,3,4 2 3 4 Hussain Farrukh fhussain017@gmail.com 1 Duru Firat 1 Section of Cardiology Department of Internal Medicine University of Manitoba Winnipeg MB Canada R2H 2A6 umanitoba.ca 2 Institute of Cardiovascular Sciences St. Boniface Research Centre University of Manitoba Winnipeg MB Canada R2H 2A6 umanitoba.ca 3 Section of Oncology Department of Internal Medicine University of Manitoba Winnipeg MB Canada R2H 2A6 umanitoba.ca 4 Department of Radiology University of Manitoba Winnipeg MB Canada R2H 2A6 umanitoba.ca 2016 1812016 2016 26 09 2015 22 11 2015 16 12 2015 2016 Copyright © 2016 Anjala Chelvanathan et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Objective. Out of hospital cardiac arrest (OHCA) patients are a critically ill patient population with high mortality. Combining mild therapeutic hypothermia (MTH) with early coronary intervention may improve outcomes in this population. The aim of this study was to evaluate predictors of mortality in OHCA patients undergoing MTH with and without cardiac catheterization. Design. A retrospective cohort of OHCA patients who underwent MTH with catheterization (MTH + C) and without catheterization (MTH + NC) between 2006 and 2011 was analyzed at a single tertiary care centre. Predictors of in-hospital mortality and neurologic outcome were determined. Results. The study population included 176 patients who underwent MTH for OHCA. A total of 66 patients underwent cardiac catheterization (MTH + C) and 110 patients did not undergo cardiac catheterization (MTH + NC). Immediate bystander CPR occurred in approximately half of the total population. In the MTH + C and MTH + NC groups, the in-hospital mortality was 48% and 78%, respectively. The only independent predictor of in-hospital mortality for patients with MTH + C, after multivariate analysis, was baseline renal insufficiency (OR = 8.2, 95% CI 1.8–47.1, and p = 0.009). Conclusion. Despite early cardiac catheterization, renal insufficiency and the absence of immediate CPR are potent predictors of death and poor neurologic outcome in patients with OHCA.