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: 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.
  
  
  
  The TTM trial randomized 939 patients to TTM at 33 or 36°C for 24h. Patients were categorized according to their recorded body temperature on arrival and also categorized to groups of patients being actively cooled or passively rewarmed.
  
  
  
  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 4h 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.
  
  
  
  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.
authors: Department of Anesthesia and Intensive Care, Oslo University Hospital, Rikshospitalet, Oslo, Norway. Electronic address: jan.hovdenes@ous-hf.no.
authors: Jan
authors: J
authors: Hovdenes
authors: Department of Biostatistics, Institute of Basical Medical Sciences, University of Oslo, Norway.
authors: Kjetil
authors: K
authors: Røysland
authors: Department of Anesthesia and Intensive Care, Helsingborg Hospital, Helsingborg, Sweden.
authors: Niklas
authors: N
authors: Nielsen
authors: The Heart Centre, Copenhagen University Hospital, Copenhagen, Denmark.
authors: Jesper
authors: J
authors: Kjaergaard
authors: The Heart Centre, Copenhagen University Hospital, Copenhagen, Denmark.
authors: Michael
authors: M
authors: Wanscher
authors: The Heart Centre, Copenhagen University Hospital, Copenhagen, Denmark.
authors: Christian
authors: C
authors: Hassager
authors: Copenhagen Trial Unit, Rigshospitalet, Copenhagen, Denmark.
authors: Jørn
authors: J
authors: Wetterslev
authors: Department of Neurology, Skåne University Hospital, Lund, Sweden.
authors: Tobias
authors: T
authors: Cronberg
authors: Department of Cardiology, Clinical Sciences Lund University, Skåne University Hospital, Lund, Sweden.
authors: David
authors: D
authors: Erlinge
authors: Department of Anesthesia and Intensive Care, Skåne University Hospital, Lund, University of Lund, Sweden.
authors: Hans
authors: H
authors: Friberg
authors: Department of Intensive Care, Geneva University Hospital, Geneva, Switzerland.
authors: Yvan
authors: Y
authors: Gasche
authors: Department of Intensive Care, Academic Medical Center, Amsterdam, The Netherlands.
authors: Janneke
authors: J
authors: Horn
authors: Department of Intensive Care, Medical Centrum Leeuwarden, Leeuwarden, The Netherlands.
authors: Michael
authors: M
authors: Kuiper
authors: Department of Intensive Care, Santa Maria degli Angeli, Pordenone, Italy.
authors: Tommaso
authors: T
authors: Pellis
authors: Department of Anesthesia and Intensive Care, Centre Hospitalier de Luxembourg, Luxembourg.
authors: Pascal
authors: P
authors: Stammet
authors: Department of Intensive Care, University Hospital of Wales, Cardiff, United Kingdom.
authors: Matthew P
authors: MP
authors: Wise
authors: Department of Intensive Care, Liverpool hospital, Sydney, New South Wales, Australia.
authors: Anders
authors: A
authors: Åneman
authors: Department of Anesthesia and Intensive Care, Oslo University Hospital, Rikshospitalet, Oslo, Norway.
authors: Jan Frederik
authors: JF
authors: Bugge
mesh_terms: D000328:Adult; D000368:Aged; D001831:Body Temperature; D016887:Cardiopulmonary Resuscitation / Q000009:adverse effects / Q000379:methods; D005260:Female; D006801:Humans; D007036:Hypothermia, Induced / Q000379:methods*; D008297:Male; D008875:Middle Aged; D009026:Mortality; D058687:Out-of-Hospital Cardiac Arrest / Q000175:diagnosis / Q000401:mortality / Q000503:physiopathology / Q000628:therapy*; D013997:Time Factors; D016896:Treatment Outcome
keywords: Body temperature on arrival at hospital; Cardiac arrest; Temperature management