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

Jan Hovdenes; Kjetil Røysland; Niklas Nielsen; Jesper Kjaergaard; Michael Wanscher; Christian Hassager; Jørn Wetterslev; Tobias Cronberg; David Erlinge; Hans Friberg; Yvan Gasche; Janneke Horn; Michael Kuiper; Tommaso Pellis; Pascal Stammet; Matthew P. Wise; Anders Åneman; Jan Frederik Bugge

doi:10.1016/j.resuscitation.2016.08.011

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

Jan Hovdenes^*, Kjetil Røysland, Niklas Nielsen, Jesper Kjaergaard, Michael Wanscher, Christian Hassager, Jørn Wetterslev, Tobias Cronberg, David Erlinge, Hans Friberg, Yvan Gasche, Janneke Horn, Michael Kuiper, Tommaso Pellis, Pascal Stammet, Matthew P. Wise, Anders Åneman, Jan Frederik Bugge

^*Corresponding author for this work

Research output: Contribution to journal › Article › peer-review

16 Citations (Scopus)

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 (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.

Original language	English
Pages (from-to)	102-106
Number of pages	5
Journal	Resuscitation
Volume	107
DOIs	https://doi.org/10.1016/j.resuscitation.2016.08.011
Publication status	Published - 1 Oct 2016
Externally published	Yes

Keywords

Body temperature on arrival at hospital
Cardiac arrest
Temperature management

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10.1016/j.resuscitation.2016.08.011

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Hovdenes, J., Røysland, K., Nielsen, N., Kjaergaard, J., Wanscher, M., Hassager, C., Wetterslev, J., Cronberg, T., Erlinge, D., Friberg, H., Gasche, Y., Horn, J., Kuiper, M., Pellis, T., Stammet, P., Wise, M. P., Åneman, A., & Bugge, J. F. (2016). A low body temperature on arrival at hospital following out-of-hospital-cardiac-arrest is associated with increased mortality in the TTM-study. Resuscitation, 107, 102-106. https://doi.org/10.1016/j.resuscitation.2016.08.011

@article{6cbf9cfbb85c4a29862b945c06c2774e,

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

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 (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.",

keywords = "Body temperature on arrival at hospital, Cardiac arrest, Temperature management",

author = "Jan Hovdenes and Kjetil R{\o}ysland and Niklas Nielsen and Jesper Kjaergaard and Michael Wanscher and Christian Hassager and J{\o}rn Wetterslev and Tobias Cronberg and David Erlinge and Hans Friberg and Yvan Gasche and Janneke Horn and Michael Kuiper and Tommaso Pellis and Pascal Stammet and Wise, {Matthew P.} and Anders {\AA}neman and Bugge, {Jan Frederik}",

year = "2016",

month = oct,

day = "1",

doi = "10.1016/j.resuscitation.2016.08.011",

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Hovdenes, J, Røysland, K, Nielsen, N, Kjaergaard, J, Wanscher, M, Hassager, C, Wetterslev, J, Cronberg, T, Erlinge, D, Friberg, H, Gasche, Y, Horn, J, Kuiper, M, Pellis, T, Stammet, P, Wise, MP, Åneman, A & Bugge, JF 2016, 'A low body temperature on arrival at hospital following out-of-hospital-cardiac-arrest is associated with increased mortality in the TTM-study', Resuscitation, vol. 107, pp. 102-106. https://doi.org/10.1016/j.resuscitation.2016.08.011

TY - JOUR

T1 - A low body temperature on arrival at hospital following out-of-hospital-cardiac-arrest is associated with increased mortality in the TTM-study

AU - Hovdenes, Jan

AU - Røysland, Kjetil

AU - Nielsen, Niklas

AU - Kjaergaard, Jesper

AU - Wanscher, Michael

AU - Hassager, Christian

AU - Wetterslev, Jørn

AU - Cronberg, Tobias

AU - Erlinge, David

AU - Friberg, Hans

AU - Gasche, Yvan

AU - Horn, Janneke

AU - Kuiper, Michael

AU - Pellis, Tommaso

AU - Stammet, Pascal

AU - Wise, Matthew P.

AU - Åneman, Anders

AU - Bugge, Jan Frederik

PY - 2016/10/1

Y1 - 2016/10/1

N2 - 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.

AB - 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.

KW - Body temperature on arrival at hospital

KW - Cardiac arrest

KW - Temperature management

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U2 - 10.1016/j.resuscitation.2016.08.011

DO - 10.1016/j.resuscitation.2016.08.011

M3 - Article

C2 - 27565034

AN - SCOPUS:84984696192

SN - 0300-9572

VL - 107

SP - 102

EP - 106

JO - Resuscitation

JF - Resuscitation

ER -

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

Abstract

Keywords

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