The effect of different target temperatures in targeted temperature management on neurologically favorable outcome after out-of-hospital cardiac arrest: A nationwide multicenter observational study in Japan (the JAAM-OHCA registry)

It has been insufficiently investigated whether neurological function after out-of-hospital cardiac arrest (OHCA) would differ by 1 °C change in ordered target temperature of 33–36 °C among patients undergoing targeted temperature management (TTM) in the real-world setting. This nationwide hospital-...

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Published inResuscitation Vol. 133; pp. 82 - 87
Main Authors Irisawa, Taro, Matsuyama, Tasuku, Iwami, Taku, Yamada, Tomoki, Hayakawa, Koichi, Yoshiya, Kazuhisa, Noguchi, Kazuo, Nishimura, Tetsuro, Uejima, Toshifumi, Yagi, Yoshiki, Kiguchi, Takeyuki, Kishimoto, Masafumi, Matsuura, Makoto, Hayashi, Yasuyuki, Sogabe, Taku, Morooka, Takaya, Kitamura, Tetsuhisa, Shimazu, Takeshi
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Published Ireland Elsevier B.V 01.12.2018
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Abstract It has been insufficiently investigated whether neurological function after out-of-hospital cardiac arrest (OHCA) would differ by 1 °C change in ordered target temperature of 33–36 °C among patients undergoing targeted temperature management (TTM) in the real-world setting. This nationwide hospital-based observational study (The Japanese Association for Acute Medicine-OHCA Registry) conducted between June 2014 and December 2015 in Japan included OHCA patients aged ≥18 years who were treated with TTM. The primary outcome was one-month survival with neurologically favorable outcomes defined by cerebral performance category 1 or 2. To investigate the effect of TTM by 1 °C change in ordered target temperature of 33–36 °C on each outcome, random effects logistic regression analyses were performed. The final analysis included 738 patients. The proportion of patients with neurologically favorable outcome was 30.4% (7/23), 31.7% (175/552), 28.9% (11/38), and 30.4% (38/125) in the 33 °C, 34 °C, 35 °C, and 36 °C groups, respectively. In the multivariable logistic regression analysis, no group had a higher proportion of neurologically favorable outcome compared with the 34 °C group (vs. 33 °C group, adjusted odds ratio [AOR] 0.90; 95% confidence interval [CI] 0.25–3.12, vs. 35 °C group, AOR 1.17; 95% CI 0.44–3.13, vs. 36 °C group, AOR 1.26; 95% CI 0.78–2.02). In this population, we evaluated the difference in outcomes after adult OHCA patients received TTM by 1 °C change in ordered target temperature of 33–36 °C and demonstrated that there was no statistically significant difference in neurologically favorable outcomes after OHCA irrespective of target temperature.
AbstractList It has been insufficiently investigated whether neurological function after out-of-hospital cardiac arrest (OHCA) would differ by 1 °C change in ordered target temperature of 33-36 °C among patients undergoing targeted temperature management (TTM) in the real-world setting.BACKGROUNDIt has been insufficiently investigated whether neurological function after out-of-hospital cardiac arrest (OHCA) would differ by 1 °C change in ordered target temperature of 33-36 °C among patients undergoing targeted temperature management (TTM) in the real-world setting.This nationwide hospital-based observational study (The Japanese Association for Acute Medicine-OHCA Registry) conducted between June 2014 and December 2015 in Japan included OHCA patients aged ≥18 years who were treated with TTM. The primary outcome was one-month survival with neurologically favorable outcomes defined by cerebral performance category 1 or 2. To investigate the effect of TTM by 1 °C change in ordered target temperature of 33-36 °C on each outcome, random effects logistic regression analyses were performed.METHODSThis nationwide hospital-based observational study (The Japanese Association for Acute Medicine-OHCA Registry) conducted between June 2014 and December 2015 in Japan included OHCA patients aged ≥18 years who were treated with TTM. The primary outcome was one-month survival with neurologically favorable outcomes defined by cerebral performance category 1 or 2. To investigate the effect of TTM by 1 °C change in ordered target temperature of 33-36 °C on each outcome, random effects logistic regression analyses were performed.The final analysis included 738 patients. The proportion of patients with neurologically favorable outcome was 30.4% (7/23), 31.7% (175/552), 28.9% (11/38), and 30.4% (38/125) in the 33 °C, 34 °C, 35 °C, and 36 °C groups, respectively. In the multivariable logistic regression analysis, no group had a higher proportion of neurologically favorable outcome compared with the 34 °C group (vs. 33 °C group, adjusted odds ratio [AOR] 0.90; 95% confidence interval [CI] 0.25-3.12, vs. 35 °C group, AOR 1.17; 95% CI 0.44-3.13, vs. 36 °C group, AOR 1.26; 95% CI 0.78-2.02).RESULTSThe final analysis included 738 patients. The proportion of patients with neurologically favorable outcome was 30.4% (7/23), 31.7% (175/552), 28.9% (11/38), and 30.4% (38/125) in the 33 °C, 34 °C, 35 °C, and 36 °C groups, respectively. In the multivariable logistic regression analysis, no group had a higher proportion of neurologically favorable outcome compared with the 34 °C group (vs. 33 °C group, adjusted odds ratio [AOR] 0.90; 95% confidence interval [CI] 0.25-3.12, vs. 35 °C group, AOR 1.17; 95% CI 0.44-3.13, vs. 36 °C group, AOR 1.26; 95% CI 0.78-2.02).In this population, we evaluated the difference in outcomes after adult OHCA patients received TTM by 1 °C change in ordered target temperature of 33-36 °C and demonstrated that there was no statistically significant difference in neurologically favorable outcomes after OHCA irrespective of target temperature.CONCLUSIONSIn this population, we evaluated the difference in outcomes after adult OHCA patients received TTM by 1 °C change in ordered target temperature of 33-36 °C and demonstrated that there was no statistically significant difference in neurologically favorable outcomes after OHCA irrespective of target temperature.
It has been insufficiently investigated whether neurological function after out-of-hospital cardiac arrest (OHCA) would differ by 1 °C change in ordered target temperature of 33–36 °C among patients undergoing targeted temperature management (TTM) in the real-world setting. This nationwide hospital-based observational study (The Japanese Association for Acute Medicine-OHCA Registry) conducted between June 2014 and December 2015 in Japan included OHCA patients aged ≥18 years who were treated with TTM. The primary outcome was one-month survival with neurologically favorable outcomes defined by cerebral performance category 1 or 2. To investigate the effect of TTM by 1 °C change in ordered target temperature of 33–36 °C on each outcome, random effects logistic regression analyses were performed. The final analysis included 738 patients. The proportion of patients with neurologically favorable outcome was 30.4% (7/23), 31.7% (175/552), 28.9% (11/38), and 30.4% (38/125) in the 33 °C, 34 °C, 35 °C, and 36 °C groups, respectively. In the multivariable logistic regression analysis, no group had a higher proportion of neurologically favorable outcome compared with the 34 °C group (vs. 33 °C group, adjusted odds ratio [AOR] 0.90; 95% confidence interval [CI] 0.25–3.12, vs. 35 °C group, AOR 1.17; 95% CI 0.44–3.13, vs. 36 °C group, AOR 1.26; 95% CI 0.78–2.02). In this population, we evaluated the difference in outcomes after adult OHCA patients received TTM by 1 °C change in ordered target temperature of 33–36 °C and demonstrated that there was no statistically significant difference in neurologically favorable outcomes after OHCA irrespective of target temperature.
Author Kiguchi, Takeyuki
Sogabe, Taku
Yamada, Tomoki
Uejima, Toshifumi
Matsuura, Makoto
Kishimoto, Masafumi
Morooka, Takaya
Iwami, Taku
Shimazu, Takeshi
Irisawa, Taro
Nishimura, Tetsuro
Hayakawa, Koichi
Matsuyama, Tasuku
Kitamura, Tetsuhisa
Noguchi, Kazuo
Yagi, Yoshiki
Hayashi, Yasuyuki
Yoshiya, Kazuhisa
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  organization: Department of Critical Care Medicine, Osaka City University, Osaka, Japan
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  givenname: Toshifumi
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  organization: Osaka Mishima Emergency Critical Care Center, Takatsuki, Japan
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  fullname: Kiguchi, Takeyuki
  organization: Department of Traumatology and Acute Critical Medicine, Osaka University Graduate School of Medicine, Suita, Japan
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  givenname: Masafumi
  surname: Kishimoto
  fullname: Kishimoto, Masafumi
  organization: Osaka Prefectural Nakakawachi Medical Center of Acute Medicine, Higashi, Osaka, Japan
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  givenname: Makoto
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  fullname: Matsuura, Makoto
  organization: Senshu Trauma and Critical Care Center, Osaka, Japan
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  givenname: Yasuyuki
  surname: Hayashi
  fullname: Hayashi, Yasuyuki
  organization: Senri Critical Care Medical Center, Saiseikai Senri Hospital, Suita, Japan
– sequence: 15
  givenname: Taku
  surname: Sogabe
  fullname: Sogabe, Taku
  organization: Traumatology and Critical Care Medical Center, National Hospital Organization Osaka National Hospital, Osaka, Japan
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  givenname: Takaya
  surname: Morooka
  fullname: Morooka, Takaya
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– sequence: 17
  givenname: Tetsuhisa
  surname: Kitamura
  fullname: Kitamura, Tetsuhisa
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  givenname: Takeshi
  surname: Shimazu
  fullname: Shimazu, Takeshi
  organization: Department of Traumatology and Acute Critical Medicine, Osaka University Graduate School of Medicine, Suita, Japan
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Keywords Out-of-hospital cardiac arrest
Post-cardiac arrest syndrome
Neurologically favorable outcome
Targeted temperature management
Language English
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Snippet It has been insufficiently investigated whether neurological function after out-of-hospital cardiac arrest (OHCA) would differ by 1 °C change in ordered target...
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StartPage 82
SubjectTerms Neurologically favorable outcome
Out-of-hospital cardiac arrest
Post-cardiac arrest syndrome
Targeted temperature management
Title The effect of different target temperatures in targeted temperature management on neurologically favorable outcome after out-of-hospital cardiac arrest: A nationwide multicenter observational study in Japan (the JAAM-OHCA registry)
URI https://www.clinicalkey.com/#!/content/1-s2.0-S030095721830981X
https://dx.doi.org/10.1016/j.resuscitation.2018.10.004
https://www.ncbi.nlm.nih.gov/pubmed/30316953
https://www.proquest.com/docview/2120192973
Volume 133
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