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Bleeding complications after cardiac arrest and targeted temperature management, a post hoc study of the targeted temperature management trial

Kander, Thomas LU orcid ; Ullén, Susann ; Dankiewicz, Josef LU orcid ; Wise, MP ; Schött, Ulf LU and Rundgren, Malin LU (2019) In Therapeutic hypothermia and temperature management 9(3). p.177-183
Abstract
Target Temperature Management (TTM) is standard care following out of hospital cardiac arrest (OHCA). The aim of the study was to evaluate if treatment temperature (33°C or 36°C) or other predefined variables were associated with the occurrence of bleeding in the TTM study. This study is a predefined, post hoc analysis of the TTM trial, a multinational randomized controlled trial comparing treatment at 33°C and 36°C for 24 hours after OHCA with return of spontaneous circulation. Bleeding events from several locations were registered daily. The main outcome measure was occurrence of any bleeding during the first 3 days of intensive care. Risk factors for bleeding, including temperature allocation, were evaluated. Complete data were... (More)
Target Temperature Management (TTM) is standard care following out of hospital cardiac arrest (OHCA). The aim of the study was to evaluate if treatment temperature (33°C or 36°C) or other predefined variables were associated with the occurrence of bleeding in the TTM study. This study is a predefined, post hoc analysis of the TTM trial, a multinational randomized controlled trial comparing treatment at 33°C and 36°C for 24 hours after OHCA with return of spontaneous circulation. Bleeding events from several locations were registered daily. The main outcome measure was occurrence of any bleeding during the first 3 days of intensive care. Risk factors for bleeding, including temperature allocation, were evaluated. Complete data were available for 722/939 patients. Temperature allocation was not associated with bleeding either in the univariable (p = 0.95) or in the primary multivariable analysis (odds ratio [OR] 0.95; 95% confidence interval [CI] 0.64–1.41, p = 0.80). A multiple imputation model, including all patients, was used as a sensitivity analysis, rendering similar results (OR 0.98; 95% CI 0.69–1.38, p = 0.92). Factors associated with bleeding were increasing age, female sex, and angiography with percutaneous coronary intervention (PCI) within 36 hours of cardiac arrest (CA) in both the primary and the sensitivity analysis. TTM at 33°C, when compared to TTM at 36°C, was not associated with an increased incidence of bleeding during the first 3 days of intensive care after CA. Increasing age, female gender, and PCI were independently associated with any bleeding the first 3 days after CA. (Less)
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author
; ; ; ; and
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
bleeding, cardiac arrest, coagulation, hypothermia, targeted temperature management
in
Therapeutic hypothermia and temperature management
volume
9
issue
3
pages
7 pages
publisher
Mary Ann Liebert, Inc.
external identifiers
  • scopus:85071954825
  • pmid:30523732
ISSN
2153-7933
DOI
10.1089/ther.2018.0024
project
Koagulation vid kirurgi och kritisk sjukdom
language
English
LU publication?
yes
id
7f43d1cb-8f86-4fed-82bd-012fb2b817a4
date added to LUP
2018-12-16 12:55:41
date last changed
2024-04-15 18:38:30
@article{7f43d1cb-8f86-4fed-82bd-012fb2b817a4,
  abstract     = {{Target Temperature Management (TTM) is standard care following out of hospital cardiac arrest (OHCA). The aim of the study was to evaluate if treatment temperature (33°C or 36°C) or other predefined variables were associated with the occurrence of bleeding in the TTM study. This study is a predefined, post hoc analysis of the TTM trial, a multinational randomized controlled trial comparing treatment at 33°C and 36°C for 24 hours after OHCA with return of spontaneous circulation. Bleeding events from several locations were registered daily. The main outcome measure was occurrence of any bleeding during the first 3 days of intensive care. Risk factors for bleeding, including temperature allocation, were evaluated. Complete data were available for 722/939 patients. Temperature allocation was not associated with bleeding either in the univariable (p = 0.95) or in the primary multivariable analysis (odds ratio [OR] 0.95; 95% confidence interval [CI] 0.64–1.41, p = 0.80). A multiple imputation model, including all patients, was used as a sensitivity analysis, rendering similar results (OR 0.98; 95% CI 0.69–1.38, p = 0.92). Factors associated with bleeding were increasing age, female sex, and angiography with percutaneous coronary intervention (PCI) within 36 hours of cardiac arrest (CA) in both the primary and the sensitivity analysis. TTM at 33°C, when compared to TTM at 36°C, was not associated with an increased incidence of bleeding during the first 3 days of intensive care after CA. Increasing age, female gender, and PCI were independently associated with any bleeding the first 3 days after CA.}},
  author       = {{Kander, Thomas and Ullén, Susann and Dankiewicz, Josef and Wise, MP and Schött, Ulf and Rundgren, Malin}},
  issn         = {{2153-7933}},
  keywords     = {{bleeding; cardiac arrest; coagulation; hypothermia; targeted temperature management}},
  language     = {{eng}},
  month        = {{09}},
  number       = {{3}},
  pages        = {{177--183}},
  publisher    = {{Mary Ann Liebert, Inc.}},
  series       = {{Therapeutic hypothermia and temperature management}},
  title        = {{Bleeding complications after cardiac arrest and targeted temperature management, a post hoc study of the targeted temperature management trial}},
  url          = {{http://dx.doi.org/10.1089/ther.2018.0024}},
  doi          = {{10.1089/ther.2018.0024}},
  volume       = {{9}},
  year         = {{2019}},
}