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A low body temperature on arrival at hospital following out-of-hospital-cardiac-arrest is associated with increased mortality in the TTM-study

Hovdenes, Jan; Røysland, Kjetil; Nielsen, Niklas LU ; Kjaergaard, Jesper; Wanscher, Michael; Hassager, Christian; Wetterslev, Jørn; Cronberg, Tobias LU ; Erlinge, David LU and Friberg, Hans LU , et al. (2016) In Resuscitation 107. p.102-106
Abstract

Aim To investigate the association of temperature on arrival to hospital after out-of-hospital-cardiac arrest (OHCA) with the primary outcome of mortality, in the targeted temperature management (TTM) trial. Methods The TTM trial randomized 939 patients to TTM at 33 or 36 °C for 24 h. Patients were categorized according to their recorded body temperature on arrival and also categorized to groups of patients being actively cooled or passively rewarmed. Results OHCA patients having a temperature ≤34.0 °C on arrival at hospital had a significantly higher mortality compared to the OHCA patients with a higher temperature on arrival. A low body temperature on arrival was associated with a longer time to return of spontaneous circulation... (More)

Aim To investigate the association of temperature on arrival to hospital after out-of-hospital-cardiac arrest (OHCA) with the primary outcome of mortality, in the targeted temperature management (TTM) trial. Methods The TTM trial randomized 939 patients to TTM at 33 or 36 °C for 24 h. Patients were categorized according to their recorded body temperature on arrival and also categorized to groups of patients being actively cooled or passively rewarmed. Results OHCA patients having a temperature ≤34.0 °C on arrival at hospital had a significantly higher mortality compared to the OHCA patients with a higher temperature on arrival. A low body temperature on arrival was associated with a longer time to return of spontaneous circulation (ROSC) and duration of transport time to hospital. Patients who were actively cooled or passively rewarmed during the first 4 h had similar mortality. In a multivariate logistic regression model mortality was significantly related to time from OHCA to ROSC, time from OHCA to advanced life support (ALS), age, sex and first registered rhythm. None of the temperature related variables (included the TTM-groups) were significantly related to mortality. Conclusion OHCA patients with a temperature ≤34.0 °C on arrival have a higher mortality than patients with a temperature ≥34.1 °C on arrival. A low temperature on arrival is associated with a long time to ROSC. Temperature changes and TTM-groups were not associated with mortality in a regression model.

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Contribution to journal
publication status
published
subject
keywords
Body temperature on arrival at hospital, Cardiac arrest, Temperature management
in
Resuscitation
volume
107
pages
5 pages
publisher
Elsevier
external identifiers
  • Scopus:84984696192
ISSN
0300-9572
DOI
10.1016/j.resuscitation.2016.08.011
language
English
LU publication?
yes
id
22245d61-7b34-49a4-a906-d88c3ecb1ee5
date added to LUP
2016-09-29 12:14:40
date last changed
2016-11-17 12:53:10
@misc{22245d61-7b34-49a4-a906-d88c3ecb1ee5,
  abstract     = {<p>Aim To investigate the association of temperature on arrival to hospital after out-of-hospital-cardiac arrest (OHCA) with the primary outcome of mortality, in the targeted temperature management (TTM) trial. Methods The TTM trial randomized 939 patients to TTM at 33 or 36 °C for 24 h. Patients were categorized according to their recorded body temperature on arrival and also categorized to groups of patients being actively cooled or passively rewarmed. Results OHCA patients having a temperature ≤34.0 °C on arrival at hospital had a significantly higher mortality compared to the OHCA patients with a higher temperature on arrival. A low body temperature on arrival was associated with a longer time to return of spontaneous circulation (ROSC) and duration of transport time to hospital. Patients who were actively cooled or passively rewarmed during the first 4 h had similar mortality. In a multivariate logistic regression model mortality was significantly related to time from OHCA to ROSC, time from OHCA to advanced life support (ALS), age, sex and first registered rhythm. None of the temperature related variables (included the TTM-groups) were significantly related to mortality. Conclusion OHCA patients with a temperature ≤34.0 °C on arrival have a higher mortality than patients with a temperature ≥34.1 °C on arrival. A low temperature on arrival is associated with a long time to ROSC. Temperature changes and TTM-groups were not associated with mortality in a regression model.</p>},
  author       = {Hovdenes, Jan and Røysland, Kjetil and Nielsen, Niklas and Kjaergaard, Jesper and Wanscher, Michael and Hassager, Christian and Wetterslev, Jørn and Cronberg, Tobias and Erlinge, David and Friberg, Hans and Gasche, Yvan and Horn, Janneke and Kuiper, Michael and Pellis, Tommaso and Stammet, Pascal and Wise, Matthew P. and Åneman, Anders and Bugge, Jan Frederik},
  issn         = {0300-9572},
  keyword      = {Body temperature on arrival at hospital,Cardiac arrest,Temperature management},
  language     = {eng},
  month        = {10},
  pages        = {102--106},
  publisher    = {ARRAY(0x9b9d408)},
  series       = {Resuscitation},
  title        = {A low body temperature on arrival at hospital following out-of-hospital-cardiac-arrest is associated with increased mortality in the TTM-study},
  url          = {http://dx.doi.org/10.1016/j.resuscitation.2016.08.011},
  volume       = {107},
  year         = {2016},
}