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
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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. / TTM-Trial Investigators.
I: Minerva Anestesiologica, Bind 85, Nr. 7, 07.2019, s. 738-745.Publikation: Bidrag til tidsskrift › Tidsskriftartikel › Forskning › fagfællebedømt
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T1 - 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
AU - Andréll, Cecilia
AU - Dankiewicz, Josef
AU - Hassager, Christian
AU - Horn, Janneke
AU - Kjærgaard, Jesper
AU - Winther-Jensen, Matilde
AU - Wise, Matt P
AU - Nielsen, Niklas
AU - Stammet, Pascal
AU - Friberg, Hans
AU - TTM-Trial Investigators
PY - 2019/7
Y1 - 2019/7
N2 - BACKGROUND: The majority of out-of-hospital cardiac arrests (OHCAs) occur at place of 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 (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 versus 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 arrest at place of residence which was independently associated with poor outcomes. Actions to improve outcomes after OHCA at place of residence should be addressed in future trials.
AB - BACKGROUND: The majority of out-of-hospital cardiac arrests (OHCAs) occur at place of 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 (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 versus 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 arrest at place of residence which was independently associated with poor outcomes. Actions to improve outcomes after OHCA at place of residence should be addressed in future trials.
U2 - 10.23736/S0375-9393.18.12878-1
DO - 10.23736/S0375-9393.18.12878-1
M3 - Journal article
C2 - 30481998
VL - 85
SP - 738
EP - 745
JO - Minerva Anestesiologica
JF - Minerva Anestesiologica
SN - 0375-9393
IS - 7
ER -
ID: 234450881