Abstract | OBJECTIVES: DESIGN: An observational cohort study evaluating the association of targeted temperature management processes with survival and neurological function using bivariate and generalized estimating equation analyses. SETTING: Thirty-two tertiary and community hospitals in eight urban and rural regions of southern Ontario, Canada. PATIENTS: INTERVENTIONS: Evaluate the association of targeted temperature management processes with survival and neurologic function using bivariate and generalized estimating equation analyses. MEASUREMENTS AND MAIN RESULTS: There were 5,770 consecutive out-of-hospital cardiac arrest patients, of whom 747 (12.9%) were eligible and received targeted temperature management. Among patients with available outcome data, 365 of 738 (49.5%) survived to hospital discharge and 241 of 675 (35.7%) had good neurological outcomes. After adjusting for the Utstein variables, a higher temperature prior to initiation of targeted temperature management was associated with improved neurological outcomes (odds ratio, 1.27 per °C; 95% CI, 1.08-1.50; p = 0.004) and survival (odds ratio, 1.26 per °C; 95% CI, 1.09-1.46; p = 0.002). A slower rate of cooling was associated with improved neurological outcomes (odds ratio, 0.74 per °C/hr; 95% CI, 0.57-0.97; p = 0.03) and survival (odds ratio, 0.73 per °C/hr; 95% CI, 0.54-1.00; p = 0.049). CONCLUSIONS:
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Authors | Steve Lin, Damon C Scales, Paul Dorian, Alexander Kiss, Matthew R Common, Steven C Brooks, Shaun G Goodman, Justin D Salciccioli, Laurie J Morrison |
Journal | Critical care medicine
(Crit Care Med)
Vol. 42
Issue 12
Pg. 2565-74
(Dec 2014)
ISSN: 1530-0293 [Electronic] United States |
PMID | 25188550
(Publication Type: Journal Article, Multicenter Study, Research Support, Non-U.S. Gov't)
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Topics |
- Age Factors
- Aged
- Aged, 80 and over
- Arrhythmias, Cardiac
(epidemiology)
- Body Temperature
- Cohort Studies
- Female
- Health Status Indicators
- Humans
- Hypothermia, Induced
(methods, mortality)
- Male
- Middle Aged
- Ontario
- Out-of-Hospital Cardiac Arrest
(epidemiology, therapy)
- Sex Factors
- Time Factors
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