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Hypothermic to ischemic ratio and mortality in post-cardiac arrest patients

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Harvard

Skrifvars, MB, Soreide, E, Sawyer, KN, Taccone, FS, Toome, V, Storm, C, Jeppesen, A, Grejs, A, Duez, CHV, Tiainen, M, Rasmussen, BS, Laitio, T, Hassager, C & Kirkegaard, H 2020, 'Hypothermic to ischemic ratio and mortality in post-cardiac arrest patients' Acta Anaesthesiologica Scandinavica, bind 64, nr. 4, s. 546-555. https://doi.org/10.1111/aas.13528

APA

Skrifvars, M. B., Soreide, E., Sawyer, K. N., Taccone, F. S., Toome, V., Storm, C., ... Kirkegaard, H. (2020). Hypothermic to ischemic ratio and mortality in post-cardiac arrest patients. Acta Anaesthesiologica Scandinavica, 64(4), 546-555. https://doi.org/10.1111/aas.13528

CBE

Skrifvars MB, Soreide E, Sawyer KN, Taccone FS, Toome V, Storm C, Jeppesen A, Grejs A, Duez CHV, Tiainen M, Rasmussen BS, Laitio T, Hassager C, Kirkegaard H. 2020. Hypothermic to ischemic ratio and mortality in post-cardiac arrest patients. Acta Anaesthesiologica Scandinavica. 64(4):546-555. https://doi.org/10.1111/aas.13528

MLA

Vancouver

Skrifvars MB, Soreide E, Sawyer KN, Taccone FS, Toome V, Storm C o.a. Hypothermic to ischemic ratio and mortality in post-cardiac arrest patients. Acta Anaesthesiologica Scandinavica. 2020 apr;64(4):546-555. https://doi.org/10.1111/aas.13528

Author

Skrifvars, Markus B ; Soreide, Eldar ; Sawyer, Kelly N ; Taccone, Fabio S ; Toome, Valdo ; Storm, Christian ; Jeppesen, Anni ; Grejs, Anders ; Duez, Christophe H V ; Tiainen, Marjaana ; Rasmussen, Bodil S ; Laitio, Timo ; Hassager, Christian ; Kirkegaard, Hans. / Hypothermic to ischemic ratio and mortality in post-cardiac arrest patients. I: Acta Anaesthesiologica Scandinavica. 2020 ; Bind 64, Nr. 4. s. 546-555.

Bibtex

@article{83c5584785aa4ba2aa0d66564838184c,
title = "Hypothermic to ischemic ratio and mortality in post-cardiac arrest patients",
abstract = "BACKGROUND: We studied the associations between ischemia and hypothermia duration, that is, the hypothermic to ischemic ratio (H/I ratio), with mortality in patients included in a trial on two durations of targeted temperature management (TTM) at 33°C.METHODS: The TTH48 (NCT01689077) trial compared 24 and 48 hours of TTM in patients after cardiac arrest. We calculated the hypothermia time from return of spontaneous circulation (ROSC) until the patient reached 37°C after TTM and the ischemic time from CA to ROSC. We compared continuous variables with the Mann-Whitney U test. Using COX regression, we studied the independent association of the logarithmically transformed H/I ratio and time to death as well as interaction between time to ROSC, hypothermia duration, and intervention group. We visualized the predictive ability of variables with receiver operating characteristic curve analysis.RESULTS: Of the 338 patients, 237 (70{\%}) survived for 6 months. The H/I ratio was 155 (IQR 111-238) in survivors and 114 (IQR 80-169) in non-survivors (P < .001). In a Cox regression model including factors associated with outcome in univariate analysis, the logarithmically transformed H/I ratio was a significant predictor of outcome (hazard ratio 0.52 (0.37-0.72, P = .001)). After removing an outlier, we found no interaction between time to ROSC and intervention group (P = .55) or hypothermia duration in quartiles (P = .07) with mortality. There was no significant difference in the area under the curve (AUC) between time to ROSC and H/I ratio (ΔAUC 0.03 95{\%} CI -0.006-0.07, P = .10).CONCLUSIONS: We did not find any consistent evidence of a modification of the effect of TTM based on ischemia duration.",
author = "Skrifvars, {Markus B} and Eldar Soreide and Sawyer, {Kelly N} and Taccone, {Fabio S} and Valdo Toome and Christian Storm and Anni Jeppesen and Anders Grejs and Duez, {Christophe H V} and Marjaana Tiainen and Rasmussen, {Bodil S} and Timo Laitio and Christian Hassager and Hans Kirkegaard",
note = "{\circledC} 2019 The Acta Anaesthesiologica Scandinavica Foundation. Published by John Wiley & Sons Ltd.",
year = "2020",
month = "4",
doi = "10.1111/aas.13528",
language = "English",
volume = "64",
pages = "546--555",
journal = "Acta Anaesthesiologica Scandinavica",
issn = "0001-5172",
publisher = "Wiley-Blackwell Munksgaard",
number = "4",

}

RIS

TY - JOUR

T1 - Hypothermic to ischemic ratio and mortality in post-cardiac arrest patients

AU - Skrifvars, Markus B

AU - Soreide, Eldar

AU - Sawyer, Kelly N

AU - Taccone, Fabio S

AU - Toome, Valdo

AU - Storm, Christian

AU - Jeppesen, Anni

AU - Grejs, Anders

AU - Duez, Christophe H V

AU - Tiainen, Marjaana

AU - Rasmussen, Bodil S

AU - Laitio, Timo

AU - Hassager, Christian

AU - Kirkegaard, Hans

N1 - © 2019 The Acta Anaesthesiologica Scandinavica Foundation. Published by John Wiley & Sons Ltd.

PY - 2020/4

Y1 - 2020/4

N2 - BACKGROUND: We studied the associations between ischemia and hypothermia duration, that is, the hypothermic to ischemic ratio (H/I ratio), with mortality in patients included in a trial on two durations of targeted temperature management (TTM) at 33°C.METHODS: The TTH48 (NCT01689077) trial compared 24 and 48 hours of TTM in patients after cardiac arrest. We calculated the hypothermia time from return of spontaneous circulation (ROSC) until the patient reached 37°C after TTM and the ischemic time from CA to ROSC. We compared continuous variables with the Mann-Whitney U test. Using COX regression, we studied the independent association of the logarithmically transformed H/I ratio and time to death as well as interaction between time to ROSC, hypothermia duration, and intervention group. We visualized the predictive ability of variables with receiver operating characteristic curve analysis.RESULTS: Of the 338 patients, 237 (70%) survived for 6 months. The H/I ratio was 155 (IQR 111-238) in survivors and 114 (IQR 80-169) in non-survivors (P < .001). In a Cox regression model including factors associated with outcome in univariate analysis, the logarithmically transformed H/I ratio was a significant predictor of outcome (hazard ratio 0.52 (0.37-0.72, P = .001)). After removing an outlier, we found no interaction between time to ROSC and intervention group (P = .55) or hypothermia duration in quartiles (P = .07) with mortality. There was no significant difference in the area under the curve (AUC) between time to ROSC and H/I ratio (ΔAUC 0.03 95% CI -0.006-0.07, P = .10).CONCLUSIONS: We did not find any consistent evidence of a modification of the effect of TTM based on ischemia duration.

AB - BACKGROUND: We studied the associations between ischemia and hypothermia duration, that is, the hypothermic to ischemic ratio (H/I ratio), with mortality in patients included in a trial on two durations of targeted temperature management (TTM) at 33°C.METHODS: The TTH48 (NCT01689077) trial compared 24 and 48 hours of TTM in patients after cardiac arrest. We calculated the hypothermia time from return of spontaneous circulation (ROSC) until the patient reached 37°C after TTM and the ischemic time from CA to ROSC. We compared continuous variables with the Mann-Whitney U test. Using COX regression, we studied the independent association of the logarithmically transformed H/I ratio and time to death as well as interaction between time to ROSC, hypothermia duration, and intervention group. We visualized the predictive ability of variables with receiver operating characteristic curve analysis.RESULTS: Of the 338 patients, 237 (70%) survived for 6 months. The H/I ratio was 155 (IQR 111-238) in survivors and 114 (IQR 80-169) in non-survivors (P < .001). In a Cox regression model including factors associated with outcome in univariate analysis, the logarithmically transformed H/I ratio was a significant predictor of outcome (hazard ratio 0.52 (0.37-0.72, P = .001)). After removing an outlier, we found no interaction between time to ROSC and intervention group (P = .55) or hypothermia duration in quartiles (P = .07) with mortality. There was no significant difference in the area under the curve (AUC) between time to ROSC and H/I ratio (ΔAUC 0.03 95% CI -0.006-0.07, P = .10).CONCLUSIONS: We did not find any consistent evidence of a modification of the effect of TTM based on ischemia duration.

U2 - 10.1111/aas.13528

DO - 10.1111/aas.13528

M3 - Journal article

VL - 64

SP - 546

EP - 555

JO - Acta Anaesthesiologica Scandinavica

JF - Acta Anaesthesiologica Scandinavica

SN - 0001-5172

IS - 4

ER -

ID: 59437816