Advanced

Out-of-hospital cardiac arrest at place of residence is associated with worse outcomes in patients admitted to intensive care : a post-hoc analysis of the Targeted Temperature Management trial

Andréll, Cecilia LU ; Dankiewicz, Josef LU ; Hassager, Christian ; Horn, Janneke ; Kjærgaard, Jesper ; Winther-Jensen, Matilde ; Wise, Matt P ; Nielsen, Niklas LU ; Stammet, Pascal and Friberg, Hans LU (2019) In Minerva Anestesiologica 85(7).
Abstract

BACKGROUND: The majority of out-of-hospital cardiac arrests (OHCAs) occur at place residence, which is associated with worse outcomes in unselected prehospital populations. Our aim was to investigate whether location of arrest was associated with outcome in a selected group of initial survivors admitted to intensive care.

METHODS: This is a post-hoc analysis of the Targeted Temperature Management after cardiac arrest trial (TTM trial), a multicenter controlled trial, randomizing 950 OHCA patients to an intervention of 33°C or 36°C. The location of cardiac arrest was defined as place of residence vs. public place or other. The outcome measures were mortality and neurological outcome, as defined by the Cerebral Performance Category... (More)

BACKGROUND: The majority of out-of-hospital cardiac arrests (OHCAs) occur at place residence, which is associated with worse outcomes in unselected prehospital populations. Our aim was to investigate whether location of arrest was associated with outcome in a selected group of initial survivors admitted to intensive care.

METHODS: This is a post-hoc analysis of the Targeted Temperature Management after cardiac arrest trial (TTM trial), a multicenter controlled trial, randomizing 950 OHCA patients to an intervention of 33°C or 36°C. The location of cardiac arrest was defined as place of residence vs. public place or other. The outcome measures were mortality and neurological outcome, as defined by the Cerebral Performance Category scale, at 180 days.

RESULTS: Approximately half of 938 included patients arrested at place of residence (53%). Location groups did not differ with respect to age (p=0.11) or witnessed arrests (p=0.48) but bystander CPR was less common (p=0.02) at place of residence. OHCA at place of residence was associated with higher 180-day mortality, 55% vs. 38% (p<0.001) and worse neurological outcome, 61% vs. 43% (p<0.001) compared with a public place or other. After adjusting for known confounders, OHCA at place of residence remained an independent predictor of mortality (p=0.007).

CONCLUSIONS: Half of all initial survivors after OHCA admitted to intensive care had an at place of residence which was independently associated with poor outcomes. Actions improve outcomes after OHCA at place of residence should be addressed in future trials.

(Less)
Please use this url to cite or link to this publication:
author
author collaboration
organization
publishing date
type
Contribution to journal
publication status
published
subject
in
Minerva Anestesiologica
volume
85
issue
7
publisher
Edizioni Minerva Medica S.p.A.
external identifiers
  • scopus:85068927134
  • pmid:30481998
ISSN
1827-1596
DOI
10.23736/S0375-9393.18.12878-1
project
Prehospitalt omhändertagande vid hjärtstopp utanför sjukhus
language
English
LU publication?
yes
id
22ea7f7b-0926-41cb-a307-e6fcf219656b
date added to LUP
2019-04-26 14:02:27
date last changed
2020-07-08 04:48:47
@article{22ea7f7b-0926-41cb-a307-e6fcf219656b,
  abstract     = {<p>BACKGROUND: The majority of out-of-hospital cardiac arrests (OHCAs) occur at place residence, which is associated with worse outcomes in unselected prehospital populations. Our aim was to investigate whether location of arrest was associated with outcome in a selected group of initial survivors admitted to intensive care.</p><p>METHODS: This is a post-hoc analysis of the Targeted Temperature Management after cardiac arrest trial (TTM trial), a multicenter controlled trial, randomizing 950 OHCA patients to an intervention of 33°C or 36°C. The location of cardiac arrest was defined as place of residence vs. public place or other. The outcome measures were mortality and neurological outcome, as defined by the Cerebral Performance Category scale, at 180 days.</p><p>RESULTS: Approximately half of 938 included patients arrested at place of residence (53%). Location groups did not differ with respect to age (p=0.11) or witnessed arrests (p=0.48) but bystander CPR was less common (p=0.02) at place of residence. OHCA at place of residence was associated with higher 180-day mortality, 55% vs. 38% (p&lt;0.001) and worse neurological outcome, 61% vs. 43% (p&lt;0.001) compared with a public place or other. After adjusting for known confounders, OHCA at place of residence remained an independent predictor of mortality (p=0.007).</p><p>CONCLUSIONS: Half of all initial survivors after OHCA admitted to intensive care had an at place of residence which was independently associated with poor outcomes. Actions improve outcomes after OHCA at place of residence should be addressed in future trials.</p>},
  author       = {Andréll, Cecilia and Dankiewicz, Josef and Hassager, Christian and Horn, Janneke and Kjærgaard, Jesper and Winther-Jensen, Matilde and Wise, Matt P and Nielsen, Niklas and Stammet, Pascal and Friberg, Hans},
  issn         = {1827-1596},
  language     = {eng},
  number       = {7},
  publisher    = {Edizioni Minerva Medica S.p.A.},
  series       = {Minerva Anestesiologica},
  title        = {Out-of-hospital cardiac arrest at place of residence is associated with worse outcomes in patients admitted to intensive care : a post-hoc analysis of the Targeted Temperature Management trial},
  url          = {http://dx.doi.org/10.23736/S0375-9393.18.12878-1},
  doi          = {10.23736/S0375-9393.18.12878-1},
  volume       = {85},
  year         = {2019},
}