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01.12.2017 | Original research | Ausgabe 1/2017 Open Access

Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine 1/2017

Targeted temperature management in cardiac arrest: survival evaluated by propensity score matching

Zeitschrift:
Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine > Ausgabe 1/2017
Autoren:
Eirik A. Buanes, Karl O. Hufthammer, Jørund Langørgen, Anne-Berit Guttormsen, Jon-Kenneth Heltne
Wichtige Hinweise

Electronic supplementary material

The online version of this article (doi:10.​1186/​s13049-017-0373-1) contains supplementary material, which is available to authorized users.

Abstract

Background

Targeted temperature management in cardiac arrest was introduced following evidence of increased survival from two controlled trials published in 2002. We wanted to investigate whether the introduction of targeted temperature management to clinical practice had increased the survival of cardiac arrest patients at Haukeland University Hospital, Norway.

Methods

We included 336 unresponsive patients admitted to the emergency department between December 2003 and December 2008 with return of spontaneous circulation following out-of-hospital cardiac arrest in the analysis. A propensity score model was developed to evaluate the survival of patients receiving intensive care treatment including targeted temperature management, compared with intensive care treatment not including targeted temperature management.

Results

Estimation of the treatment effect revealed an increase of 57 days (95% CI: 12–103, p = 0.01) in restricted mean survival during the first year after cardiac arrest for intensive care treatment including targeted temperature management.

Discussion

As with all observational studies, bias is probable. However, propensity score methodology has been used in order to reduce bias and establish causality. Although residual confounding is likely, our interpretation is that TTM increased survival for comatose OHCA patients in our hospital because survival increased well beyond the level of significance.

Conclusion

The introduction of targeted temperature management to clinical practice is likely to have increased survival for unresponsive patients following out-of-hospital cardiac arrest.
Zusatzmaterial
Additional file 1: Table S5. Distribution of the presumed cause of cardiac arrest before and after matching. (XLSX 10 kb)
13049_2017_373_MOESM1_ESM.xlsx
Literatur
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