Please use this identifier to cite or link to this item: https://ahro.austin.org.au/austinjspui/handle/1/33469
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dc.contributor.authorLilja, Gisela-
dc.contributor.authorUllén, Susann-
dc.contributor.authorDankiewicz, Josef-
dc.contributor.authorFriberg, Hans-
dc.contributor.authorLevin, Helena-
dc.contributor.authorNordström, Erik Blennow-
dc.contributor.authorHeimburg, Katarina-
dc.contributor.authorJakobsen, Janus Christian-
dc.contributor.authorAhlqvist, Marita-
dc.contributor.authorBass, Frances-
dc.contributor.authorBelohlavek, Jan-
dc.contributor.authorOlsen, Roy Bjørkholt-
dc.contributor.authorCariou, Alain-
dc.contributor.authorEastwood, Glenn M-
dc.contributor.authorFanebust, Hans Rune-
dc.contributor.authorGrejs, Anders M-
dc.contributor.authorGrimmer, Lisa-
dc.contributor.authorHammond, Naomi E-
dc.contributor.authorHovdenes, Jan-
dc.contributor.authorHrecko, Juraj-
dc.contributor.authorIten, Manuela-
dc.contributor.authorJohansen, Henriette-
dc.contributor.authorKeeble, Thomas R-
dc.contributor.authorKirkegaard, Hans-
dc.contributor.authorLascarrou, Jean-Baptiste-
dc.contributor.authorLeithner, Christoph-
dc.contributor.authorLesona, Mildred Eden-
dc.contributor.authorLevis, Anja-
dc.contributor.authorMion, Marco-
dc.contributor.authorMoseby-Knappe, Marion-
dc.contributor.authorNavarra, Leanlove-
dc.contributor.authorNordberg, Per-
dc.contributor.authorPelosi, Paolo-
dc.contributor.authorQuayle, Rachael-
dc.contributor.authorRylander, Christian-
dc.contributor.authorSandberg, Helena-
dc.contributor.authorSaxena, Manoj-
dc.contributor.authorSchrag, Claudia-
dc.contributor.authorSiranec, Michal-
dc.contributor.authorTiziano, Cassina-
dc.contributor.authorVignon, Philippe-
dc.contributor.authorWendel-Garcia, Pedro David-
dc.contributor.authorWise, Matt P-
dc.contributor.authorWright, Kim-
dc.contributor.authorNielsen, Niklas-
dc.contributor.authorCronberg, Tobias-
dc.date2023-
dc.date.accessioned2023-08-09T04:43:06Z-
dc.date.available2023-08-09T04:43:06Z-
dc.date.issued2023-08-07-
dc.identifier.citationJAMA Neurology 2023-08-07en_US
dc.identifier.issn2168-6157-
dc.identifier.urihttps://ahro.austin.org.au/austinjspui/handle/1/33469-
dc.description.abstractThe Targeted Hypothermia vs Targeted Normothermia After Out-of-Hospital Cardiac Arrest (TTM2) trial reported no difference in mortality or poor functional outcome at 6 months after out-of-hospital cardiac arrest (OHCA). This predefined exploratory analysis provides more detailed estimation of brain dysfunction for the comparison of the 2 intervention regimens. To investigate the effects of targeted hypothermia vs targeted normothermia on functional outcome with focus on societal participation and cognitive function in survivors 6 months after OHCA. This study is a predefined analysis of an international multicenter, randomized clinical trial that took place from November 2017 to January 2020 and included participants at 61 hospitals in 14 countries. A structured follow-up for survivors performed at 6 months was by masked outcome assessors. The last follow-up took place in October 2020. Participants included 1861 adult (older than 18 years) patients with OHCA who were comatose at hospital admission. At 6 months, 939 of 1861 were alive and invited to a follow-up, of which 103 of 939 declined or were missing. Randomization 1:1 to temperature control with targeted hypothermia at 33 °C or targeted normothermia and early treatment of fever (37.8 °C or higher). Functional outcome focusing on societal participation assessed by the Glasgow Outcome Scale Extended ([GOSE] 1 to 8) and cognitive function assessed by the Montreal Cognitive Assessment ([MoCA] 0 to 30) and the Symbol Digit Modalities Test ([SDMT] z scores). Higher scores represent better outcomes. At 6 months, 836 of 939 survivors with a mean age of 60 (SD, 13) (range, 18 to 88) years (700 of 836 male [84%]) participated in the follow-up. There were no differences between the 2 intervention groups in functional outcome focusing on societal participation (GOSE score, odds ratio, 0.91; 95% CI, 0.71-1.17; P = .46) or in cognitive function by MoCA (mean difference, 0.36; 95% CI,-0.33 to 1.05; P = .37) and SDMT (mean difference, 0.06; 95% CI,-0.16 to 0.27; P = .62). Limitations in societal participation (GOSE score less than 7) were common regardless of intervention (hypothermia, 178 of 415 [43%]; normothermia, 168 of 419 [40%]). Cognitive impairment was identified in 353 of 599 survivors (59%). In this predefined analysis of comatose patients after OHCA, hypothermia did not lead to better functional outcome assessed with a focus on societal participation and cognitive function than management with normothermia. At 6 months, many survivors had not regained their pre-arrest activities and roles, and mild cognitive dysfunction was common. ClinicalTrials.gov Identifier: NCT02908308.en_US
dc.language.isoeng-
dc.titleEffects of Hypothermia vs Normothermia on Societal Participation and Cognitive Function at 6 Months in Survivors After Out-of-Hospital Cardiac Arrest: A Predefined Analysis of the TTM2 Randomized Clinical Trial.en_US
dc.typeJournal Articleen_US
dc.identifier.journaltitleJAMA Neurologyen_US
dc.identifier.affiliationClinical Studies Sweden, Forum South, Skane University Hospital, Lund, Sweden.en_US
dc.identifier.affiliationCardiology, Department of Clinical Sciences Lund, Lund University, Skane University Hospital, Lund, Sweden.en_US
dc.identifier.affiliationAnesthesia and Intensive Care, Department of Clinical Sciences Lund, Lund University, Skane University Hospital, Malmö, Sweden.en_US
dc.identifier.affiliationNeurology, Department of Clinical Sciences Lund, Lund University, Skane University Hospital, Lund, Sweden.en_US
dc.identifier.affiliationCopenhagen Trial Unit, Center for Clinical Intervention Research, Copenhagen University Hospital, Copenhagen, Denmark.;Department of Regional Health Research, The Faculty of Health Sciences, University of Southern Denmark, Denmark.en_US
dc.identifier.affiliationDepartment of Anaesthesiology and Intensive Care Medicine, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Sahlgrenska University Hospital, Gothenburg, Sweden.en_US
dc.identifier.affiliationCritical Care Program, The George Institute for Global Health and UNSW Sydney, Sydney, New South Wales, Australia.;Malcolm Fisher Department of Intensive Care, Royal North Shore Hospital, Sydney, New South Wales, Australia.en_US
dc.identifier.affiliation2nd Department of Medicine-Department of Cardiovascular Medicine, First Faculty of Medicine, Charles University in Prague and General University Hospital in Prague, Czech Republic.en_US
dc.identifier.affiliationDepartment of Anesthesiology, Sørlandet Hospital, Arendal, Norway.en_US
dc.identifier.affiliationCochin University Hospital (APHP) and Paris Cité University (medical school), Paris, France.en_US
dc.identifier.affiliationIntensive Careen_US
dc.identifier.affiliationCardiac Intensive Care Unit, Haukeland University Hospital, Bergen, Norway.en_US
dc.identifier.affiliationDepartment of Intensive Care Medicine and Department of Clinical Medicine, Aarhus University Hospital, Aarhus, Denmark.en_US
dc.identifier.affiliationUniversity Hospitals Bristol and Weston NHS Trust, Bristol, United Kingdom.en_US
dc.identifier.affiliationCritical Care Program, The George Institute for Global Health and UNSW Sydney, Sydney, New South Wales, Australia.;Malcolm Fisher Department of Intensive Care, Royal North Shore Hospital, Sydney, New South Wales, Australia.en_US
dc.identifier.affiliationDepartment of Anesthesiology, Division of Emergencies and Critical Care, Oslo University Hospital, Rikshospitalet, Oslo, Norway.en_US
dc.identifier.affiliationThe 1st Department of Internal Medicine, Cardioangiology, Medical Faculty of Charles University in Hradec Králové and University Hospital Hradec Králové, Hradec Králové, Czech Republic.en_US
dc.identifier.affiliationDepartment of Intensive Care Medicine, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland.en_US
dc.identifier.affiliationDepartment of Neurology, Rikshospitalet, Oslo University Hospital, Oslo, Norway.en_US
dc.identifier.affiliationEssex Cardio Thoracic Centre, Basildon, Essex, UK Thurrock University Hospitals, Basildon, United Kingdom.;MTRC, Anglia Ruskin University Faculty of Health Education Medicine & Social Care, Chelmsford, Essex, United Kingdom.en_US
dc.identifier.affiliationResearch Center for Emergency Medicine, Emergency Department Aarhus University Hospital and Department of Clinical Medicine Aarhus University, Aarhus, Denmark.en_US
dc.identifier.affiliationMedecine Intensive Reanimation, CHU Nantes, Nantes, France.en_US
dc.identifier.affiliationCharité- Universitätsmedizin Berlin, coroporate member of Freie Universität Berlin and Humboldt- Universität-zu-Berlin, Department of Neurology, Berlin, Germany.en_US
dc.identifier.affiliationIntensive Care Unit, Wellington hospital, Wellington, New Zealand.en_US
dc.identifier.affiliationDepartment of Intensive Care Medicine, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland.;Department of Anesthesiology and Pain Medicine, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland.en_US
dc.identifier.affiliationEssex Cardio Thoracic Centre, Basildon, Essex, UK Thurrock University Hospitals, Basildon, United Kingdom.;MTRC, Anglia Ruskin University Faculty of Health Education Medicine & Social Care, Chelmsford, Essex, United Kingdom.en_US
dc.identifier.affiliationNeurology, Department of Clinical Sciences Lund, Lund University, Skane University Hospital, Lund, Sweden.en_US
dc.identifier.affiliationMedical Research Institute of New Zealand, Wellington, New Zealand.en_US
dc.identifier.affiliationCenter for Resuscitation Sciences, Department of Clinical Science and Education, Södersjukhuset, Karolinska Institutet, Stockholm, Sweden.;Function Perioperative Medicine and Intensive Care, Karolinska University Hospital, Stockholm, Sweden.en_US
dc.identifier.affiliationDepartment of Surgical Sciences and Integrated Diagnostics, University of Genoa, Genoa, Italy.;Anesthesia and Critical Care, San Martino Policlinico Hospital, IRCCS for Oncology and Neurosciences, Genoa, Italy.en_US
dc.identifier.affiliationManchester Foundation Trust, Manchester, United Kingdom.;The Greater Manchester NIHR Clinical Research Network, Manchester, United Kingdom.en_US
dc.identifier.affiliationDepartment of Surgical Sciences, Anaesthesiology and Intensive Care Medicine, Uppsala University, Sweden.en_US
dc.identifier.affiliationHallands hospital, Halmstad, Sweden.en_US
dc.identifier.affiliationSt George Hospital Clinical School, The George institute for Global Health, University of New South Wales, Sydney, New South Wales, Australia.en_US
dc.identifier.affiliationIntensive Care Department, Kantonspital St Gallen, St Gallen, Switzerland.en_US
dc.identifier.affiliation2nd Department of Medicine-Department of Cardiovascular Medicine, First Faculty of Medicine, Charles University in Prague and General University Hospital in Prague, Czech Republic.en_US
dc.identifier.affiliationCardiac anesthesia and Intensive Care department, Istituto Cardiocentro Ticino, Lugano, Switzerland.en_US
dc.identifier.affiliationMedical-surgical ICU and Inserm CIC 1435, Dupuytren University hospital, Limoges, France.en_US
dc.identifier.affiliationInstitute of Intensive Care Medicine, University Hospital Zurich, Zurich, Switzerland.en_US
dc.identifier.affiliationAdult Critical Care, University Hospital of Wales, Cardiff, United Kingdom.en_US
dc.identifier.affiliationUniversity Hospitals Bristol and Weston NHS Trust, Bristol, United Kingdom.en_US
dc.identifier.affiliationDepartment of Clinical Sciences Lund, Anaesthesia and Intensive Care and Clinical Sciences Helsingborg, Helsingborg Hospital, Lund University, Lund, Sweden.en_US
dc.identifier.affiliationNeurology, Department of Clinical Sciences Lund, Lund University, Skane University Hospital, Lund, Sweden.en_US
dc.identifier.doi10.1001/jamaneurol.2023.2536en_US
dc.type.contentTexten_US
dc.identifier.pubmedid37548968-
item.grantfulltextnone-
item.cerifentitytypePublications-
item.openairetypeJournal Article-
item.fulltextNo Fulltext-
item.openairecristypehttp://purl.org/coar/resource_type/c_18cf-
item.languageiso639-1en-
crisitem.author.deptIntensive Care-
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