Mortality in patients with hypoxic ischemic encephalopathy treated with therapeutic hypothermia

• DOI: 10.17826/cumj.1569520
• Publication Date: 2025-03-25T19:05:29Z
• Authors: Gaffari Tunç; Elif Ünver Korğalı; Gülşah Ünsal; Muhammet Ali Mutlu; Esra Akaydın Gültürk

Purpose: Hypoxic-ischemic encephalopathy is a heterogeneous clinical syndrome that occurs in the perinatal period and is characterized by altered consciousness or seizures, respiratory depression, and hypotension. The aim of this study was to evaluate mortality in hypoxic-ischemic encephalopathy patients receiving therapeutic hypothermia. Materials and Methods: The study included 97 hypoxic-ischemic encephalopathy cases who underwent therapeutic hypothermia in the Neonatal Intensive Care Unit. The cases were evaluated for mortality and were divided into two groups: group 1 (n: 9, non-survivors) and group 2 (n: 88, survivors). Demographics, diagnoses, hypoxic-ischemic encephalopathy complications, APGAR scores, blood support, and laboratory parameters were evaluated for mortality. Results: The 97 hypoxic-ischemic encephalopathy cases in this study included 40 females and 57 males. There were 9 (9.3%) cases in group 1 (non-survivors) and 88 (90.7%) cases in group 2 (survivors). The most common etiology was umbilical cord prolapse 40 (41.2%), and the mortality rate in infants who developed hypoxic-ischemic encephalopathy due to meconium aspiration syndrome was found to be significantly high (29.4%). The risk of death was found to be increased 4.6-fold by the presence of hemorrhage in the infant, 7.3-fold by acute kidney injury, 15.5-fold by thrombocytopenia, 4.6-fold by administration of fresh frozen plasma, and 12.3-fold by pulmonary hemorrhage. A 1-unit increase in the number of intubated days was associated with a 1.2-fold increase in the risk of death. Conclusion: Mortality rates were significantly higher in cases that developed Meconium aspiration syndrome associated hypoxic-ischemic encephalopathy than in hypoxic-ischemic encephalopathy cases without meconium aspiration syndrome. A low APGAR score, increased number of intubation days, acute kidney injury, thrombocytopenia, and need for fresh frozen plasma were associated with a high risk of mortality in infants receiving therapeutic hypothermia for hypoxic-ischemic encephalopathy, and the presence of meconium aspiration syndrome significantly increased this risk.