Evidence map›Paper›PMID 36442596›Full record

ArticleResuscitation2023

Time in therapeutic range for targeted temperature management and outcomes following out-of-hospital cardiac arrest.

Kevin M Wheelock, Paul S Chan, Lian Chen, James A de Lemos, P Elliott Miller, Brahmajee K Nallamothu, Saket Girotra, Rohan Khera

Abstract read
In one paragraph

Article in Resuscitation, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

  1. Article
  2. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors.

Kevin M WheelockDepartment of Internal Medicine, Yale School of Medicine, New Haven, CT, United States.
Paul S ChanDivision of Cardiology, Department of Internal Medicine, University of Missouri-Kansas City, United States; Mid America Heart Institute, Kansas City, MO, United States.
Lian ChenCenter for Outcomes Research and Evaluation, Yale-New Haven Hospital, New Haven, CT, United States.
James A de LemosDivision of Cardiology, Department of Internal Medicine, University of Texas Southwestern Medical Center, Dallas, TX, United States.
P Elliott MillerSection of Cardiovascular Medicine, Department of Internal Medicine, Yale School of Medicine, New Haven, CT, United States.
Brahmajee K NallamothuDepartment of Internal Medicine, Division of Cardiovascular Medicine, University of Michigan, Ann Arbor, MI, United States.
Saket GirotraDivision of Cardiology, Department of Internal Medicine, University of Texas Southwestern Medical Center, Dallas, TX, United States.
Rohan KheraCenter for Outcomes Research and Evaluation, Yale-New Haven Hospital, New Haven, CT, United States; Section of Cardiovascular Medicine, Department of Internal Medicine, Yale School of Medicine, New Haven, CT, United States; Section of Health Informatics, Department of Biostatistics, Yale School of Public Health, New Haven, CT, United States. Electronic address: rohan.khera@yale.edu.

Funding

Yale Clinical and Translational Science Award (U Component)UL1TR001863 · NCATS · YALE UNIVERSITY · PI John H. Krystal, LUCILA OHNO-MACHADO · 2016 to 2026
$102.9M
Evaluating and Improving Utilization of Evidence-Based Medical Therapy in Patients with Heart Failure using Automated Tools in the Electronic Health RecordK23HL153775 · NHLBI · YALE UNIVERSITY · PI KHERA, ROHAN · 2021 to 2025
$918k
NCATS NIH HHS UL1 TR001863NHLBI NIH HHS K23 HL153775
6 · The paper itself

Abstract

objectiveFor comatose survivors of out-of-hospital cardiac arrest (OHCA), current guidelines recommend targeted temperature management (TTM) with a goal temperature of 32 °C-36 °C for at least 24 h. We examined adherence to temperature targets, quantified as time-in-therapeutic range (TTR), and association of TTR with survival and neurologic outcomes.

methodsWe conducted a retrospective cohort study of the Resuscitation Outcomes Consortium-Continuous Chest Compressions trial, including adults with OHCA who underwent TTM for >12 h. We imputed continuous temperatures between consecutive temperature measurements using the linear interpolation method and calculated TTR for multiple target temperatures. The association of TTR with survival to hospital discharge and favorable neurological outcome was evaluated using hierarchical regression models. MAIN

resultsAmong 2,637 patients (mean age 62.3 years, 29.9 % female), the median duration of TTR for TTM between 32 °C-36 °C was 23 (IQR: 21-24) hours with a median time outside therapeutic range of 0.9 (IQR: 0.0-4.2) hours. In risk-adjusted analyses, there was no association of TTR of 32 °C-36 °C with overall survival (OR 1.00 [95 % CI, 0.90-1.10]) or favorable neurologic outcome (1.02 [95 % CI, 0.90-1.14]). However, in assessments of TTR 33 °C-36 °C, there was a significant association with favorable neurologic survival (OR 1.12 [1.01-1.25]) but not overall survival (OR 1.04 [0.94-1.15]).

conclusionsAmong patients with OHCA who underwent TTM, we found variability in adherence to guideline-recommended treatment targets. Higher TTR was not associated with overall survival, but for certain temperature thresholds, TTR was associated with favorable neurologic outcome.

Indexed as

Body TemperatureGuideline AdherenceHypothermia, InducedOut-of-Hospital Cardiac ArrestAdultFemaleHumansMaleMiddle AgedPractice Guidelines as TopicRetrospective StudiesTreatment Outcomecardiac arrestoutcomestargeted temperature managementtherapeutic hypothermiatime in therapeutic range

Identifiers

PMID36442596
PMCPMC9885789

What OpenQuestion holds

Textmetadata
LicenceTDM
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.