Jan Hovdenes1, Kjetil Røysland2, Niklas Nielsen3, Jesper Kjaergaard4, Michael Wanscher4, Christian Hassager4, Jørn Wetterslev5, Tobias Cronberg6, David Erlinge7, Hans Friberg8, Yvan Gasche9, Janneke Horn10, Michael Kuiper11, Tommaso Pellis12, Pascal Stammet13, Matthew P Wise14, Anders Åneman15, Jan Frederik Bugge16. 1. Department of Anesthesia and Intensive Care, Oslo University Hospital, Rikshospitalet, Oslo, Norway. Electronic address: jan.hovdenes@ous-hf.no. 2. Department of Biostatistics, Institute of Basical Medical Sciences, University of Oslo, Norway. 3. Department of Anesthesia and Intensive Care, Helsingborg Hospital, Helsingborg, Sweden. 4. The Heart Centre, Copenhagen University Hospital, Copenhagen, Denmark. 5. Copenhagen Trial Unit, Rigshospitalet, Copenhagen, Denmark. 6. Department of Neurology, Skåne University Hospital, Lund, Sweden. 7. Department of Cardiology, Clinical Sciences Lund University, Skåne University Hospital, Lund, Sweden. 8. Department of Anesthesia and Intensive Care, Skåne University Hospital, Lund, University of Lund, Sweden. 9. Department of Intensive Care, Geneva University Hospital, Geneva, Switzerland. 10. Department of Intensive Care, Academic Medical Center, Amsterdam, The Netherlands. 11. Department of Intensive Care, Medical Centrum Leeuwarden, Leeuwarden, The Netherlands. 12. Department of Intensive Care, Santa Maria degli Angeli, Pordenone, Italy. 13. Department of Anesthesia and Intensive Care, Centre Hospitalier de Luxembourg, Luxembourg. 14. Department of Intensive Care, University Hospital of Wales, Cardiff, United Kingdom. 15. Department of Intensive Care, Liverpool hospital, Sydney, New South Wales, Australia. 16. Department of Anesthesia and Intensive Care, Oslo University Hospital, Rikshospitalet, Oslo, Norway.
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 24h. 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 4h 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.
RCT Entities:
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 24h. 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 4h 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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