Abstract 156: Lower Body Temperature ’Dose’ Associated With Higher Likelihood of Survival Following Cardiac Arrest

Circulation ◽  
2019 ◽  
Vol 140 (Suppl_2) ◽  
Author(s):  
David G Buckler ◽  
Konstantinos Totolos ◽  
Nabil M Abdulhay ◽  
Alexis M Zebrowski ◽  
Benjamin S Abella
Keyword(s):  
Logistic Regression ◽  
Cardiac Arrest ◽  
Body Temperature ◽  
Vital Signs ◽  
Lower Body ◽  
Multiple Logistic Regression ◽  
Successful Resuscitation ◽  
Lower Body Temperature ◽  
Recorded Temperature ◽  
Age And Sex

Introduction: Post-cardiac arrest pyrexia is associated with poor outcomes following successful resuscitation and return of spontaneous circulation (ROSC). Prior studies have used highest recorded temperature and duration of fever as markers for the severity of pyrexic events. The objective of this research was to evaluate the association of body temperature and survival to discharge. We hypothesized that a lower body temperature “dose” in the 8 days post-arrest would be associated with a higher likelihood of survival. Methods: Using consecutive cardiac arrest cases from a single healthcare system with integrated electronic medical record (EMR), we identified cardiac arrest patients with ROSC. Vital signs for these patients, including body temperature, were queried from the EMR and linked to individual records. We included all temperature measures within 8 days of the cardiac arrest event. Patients with fewer than 5 temperature values during the study period were excluded. For each temperature observation the difference between the recorded temperature value and 37 degrees Celsius, the time since the last observation, and the product of these values was calculated. For each patient, the total ‘dose’ was calculated as the sum of these dose products. The resulting measure has units of degree*hours and represents a measure of duration about or below normal. Multiple logistic regression was used to assess the relationship between body temperature dose and survival to discharge, controlling for age and sex. Results: Between 3/2006 and 3/2016, 352 patients were linked to serial body temperature measurements. 58% were male, mean age was 61 ± 16 years, and 52% survived to discharge. The median body temperature dose measure was 28 degree*hours, (IQR: -0.6 - 98, min: -740, max 390). Results from the multiple logistic regression indicated that for every 10 degree*hour increase in patient body temperature, the odds of survival decreased 3.1 percent (OR: 0.969, p = 0.01) when controlling for age and sex. Conclusion: In this study, lower serial body temperature ‘dose’ was associated with increased odds of survival. These findings are consistent with international guidance around the strong avoidance of fever in post-arrest patients.

Abstract 395: State-Level CPR Education Legislation Associated With Higher Survival After Out-Of-Hospital Cardiac Arrest in Older Adults

Circulation ◽  
2019 ◽  
Vol 140 (Suppl_2) ◽  
Author(s):  
David G Buckler ◽  
Megan Barnes ◽  
Tyler D Alexander ◽  
Marissa Lang ◽  
Alexis M Zebrowski ◽  
...  
Keyword(s):  
Older Adults ◽  
Logistic Regression ◽  
Cardiac Arrest ◽  
State Level ◽  
Categorical Variables ◽  
Multiple Logistic Regression ◽  
Education Legislation ◽  
Chi Squared ◽  
Patient State ◽  
Hospital Cardiac Arrest

Introduction: State-level legislation requiring CPR education prior to high school graduation (CPR Legislation) is associated with an increased likelihood of community-level CPR training. CPR Legislation has also been shown to be associated with increased bystander CPR. We hypothesized that states with recent CPR Legislation would be associated with higher survival in older adults following out-of-hospital cardiac arrest (OHCA). Methods: Utilizing 2014 Medicare Claims data for emergency department (ED) visits and inpatient stays, we identified OHCA via ICD-9-CM code. CPR Legislation data was collected through online statute review. Exposure to CPR Legislation was assessed using the patient state of residence reported on the first claim. Patient dispositions were coded as home, SNF, death/hospice, rehab or other. All categories were considered survival to discharge except for death/hospice. Associations between categorical variables were assessed by chi-squared test. Multiple logistic regression was used to calculate the odds ratio associated with OHCA survival and CPR Legislation, controlling for patient age and sex. Results: In 2014, 256,277 OHCAs were identified. Mean age was 79 ±8 y, 48% were female, 23% were non-white, and survival to discharge was 22%. Prior to 2013, 4 states had passed CPR Legislation and 6 others passed legislation in 2013. These states account for 12% of OCHA for the study year. States that passed CPR Legislation in 2013 had the highest survival compared to states with earlier passage or no CPR Legislation (22.2% vs 20.6% vs. 21.8%, respectively, p < 0.001). Among those who survived to discharge, more patients were discharged home from states with 2013 CPR Legislation, than earlier or no legislation (50.8% vs. 41.3% vs. 42.8%, p <0.001). Results of the multiple logistic regression showed CPR Legislation passed in 2013 was associated with a 12% increase in the odds of survival to discharge compared to states with CPR Legislation prior to 2013 (OR: 1.12, p <0.001). Conclusion: States with CPR Legislation passed in 2013 were associated with higher survival to discharge and discharge to home, compared to earlier adopters and states with no legislation. Further work is needed to assess the mechanisms underlying this relationship.

Crypsis influences escape decisions in the Round-tailed Horned Lizard (Phrynosoma modestum)

2010 ◽  
Vol 88 (10) ◽  
pp. 1003-1010 ◽  
Author(s):  
William E. Cooper, ◽  
Wade C. Sherbrooke
Keyword(s):  
Body Temperature ◽  
Predation Risk ◽  
Upright Posture ◽  
Flight Initiation Distance ◽  
Lower Body ◽  
Running Speed ◽  
Predator Prey ◽  
Sandy Area ◽  
Lower Body Temperature ◽  
Flight Initiation

Flight initiation distance (predator–prey distance when escape begins) increases as predation risk increases. Prey should have longer flight initiation distance when their background, movement, or current posture reduces crypsis. Flight initiation distance of ectotherms may increase at lower body temperature to compensate for slower running speed. However, for cryptic prey, fleeing might increase the probability of being detected. The Round-tailed Horned Lizard ( Phrynosoma modestum Girard, 1852) is eucryptic and resembles small stones. We predicted that flight initiation distance by P. modestum is shorter among stones than on uniform sand. Because movement and upright posture disrupt crypsis, we predicted that flight initiation distance is greater after movement and when standing than when still and lying on the ground. As predicted, flight initiation distances were shorter on a rocky than sandy area, when lying flat than standing, and while immobile than after moving. We measured running speed and flight initiation distance to determine relationships among body temperature, speed, and escape decisions. Running speed and flight initiation distance were reduced at lower body temperature, suggesting that crypsis reinforced by immobility is more advantageous than longer flight initiation distance for cool, slow lizards. The lizards adjusted escape decisions to current effectiveness of crypsis and escape ability.

scholarly journals Lower body temperature in sleeping supine infants.

1995 ◽  
Vol 72 (4) ◽  
pp. 340-342 ◽  
Author(s):  
R G North ◽  
S A Petersen ◽  
M P Wailoo
Keyword(s):  
Body Temperature ◽  
Lower Body ◽  
Lower Body Temperature

scholarly journals Effectiveness Of Tepid Sponge Compresses And Plaster Compresses On Child Typhoid Patients with Fevers

2021 ◽  
Author(s):  
Dwi Hastuti ◽  
Dewi Ummu Kulsum ◽  
Siti Rahmawati Ismuhu ◽  
Oop Ropei
Keyword(s):  
Body Temperature ◽  
Typhoid Fever ◽  
Wilcoxon Test ◽  
School Age Children ◽  
P Value ◽  
Lower Body ◽  
Lower Body Temperature ◽  
Main Complaint ◽  
Before And After ◽  
Average Body

Background: Typhoid is infectious disease which is still encountered widely in various developing countries, especially those located in the tropic and subtropics. Fever is a clinincal manifestation that is often the main complaint of the sufferer. Action can be done to lower body temperature that is tepid sponge compress and plaster compress. Purpose: The purpose of this study is to determine the comparison of the effectiviness of tepid sponge compress and plaster compress of changes body temperature in school age children with typhoid fever in cibabat hospital in year 2017. Methods: The method used is quasy experiment research method with the approach of pretest and post test two design group. As many as 24 samples were taken at the patient ward of hospital Cibabat. Respondents divided into two groups namely tepid sponge compress and plaster compress by way concecutive sampling. This study was conducted for 20 minutes at each intervenstion. Data analysis used Wilcoxon test, dependen t test, and Mann-Withney. Results: Average body temperature before and after given tepid sponge compress are 38,75°C and 38,08°C with temperature different is 0,67°C. While average body temperature before and after given palster compress are 38,80°C and 38,57°C with temperature different is 0,23°C. Mann-Withney test result show that the p value = 0,000 < α = 0,05 which means bottom tepid sponge compress is more effective in lowering body temperature in scholl age children compared with plaster compress. Conclusion: Based on the result of the study, it can recommend tepid sponge compress in the implementation of nursing care to lower body temperature in typhoid fever patients.   Keywords: Fever, Plaster compress, Tepid sponge

Abstract 241: Analysis of Characteristics and Mortality by the Level of Hospital in the Patients with Cardiac Arrest; A Nation-wide Population-based Study

Circulation ◽  
2020 ◽  
Vol 142 (Suppl_4) ◽  
Author(s):  
Sijin Lee ◽  
Su Jin Kim ◽  
Sung Woo Lee ◽  
Kap Su Han ◽  
Eui Jung Lee
Keyword(s):  
Logistic Regression ◽  
Cardiac Arrest ◽  
Regression Analysis ◽  
Health Insurance ◽  
National Health Insurance ◽  
Multiple Logistic Regression Analysis ◽  
Multiple Logistic Regression ◽  
Hospital Level ◽  
Primary Groups ◽  
Level Hospital

Objectives: We intended to determine the association between hospital-level and mortality, and reveal differences in patient characteristics and potential resource utilization using the National health Insurance Service database. Methods: We selected adult patients (>20 years old) with non-traumatic cardiac arrest from 2006 to 2015 using the national database. The patients were categorized into ‘Tertiary’, ‘Secondary’ and ‘Primary’ groups by the level of hospital where they were treated. Demographics, insurance type, urbanization level, previous disease, medical therapies and hospital costs were analyzed among the groups. Primary end-points were mortality rate within 30 days, 6 months and 1 year. Multiple logistic regression analysis was utilized for determining the association between hospital-level and mortality (SAS ver 9.4). Results: Tertiary, Secondary and Primary groups accounted for 32.6%, 49.6% and 17.8% of total 337,042 patients. Tertiary and Secondary groups showed the higher proportion of younger age, male patients, coverage by national health insurance, urban residents and lower Charlson Comorbidity Index than Primary group. After adjusting characteristics and pre-existing diseases in multiple logistic regression analysis, the higher hospital level was negatively associated with mortality (Adjusted Odds ratio[aOR]: 0.372 and 0.419 at 30-days, aOR: 0.504 and 0.568 at 6-months, aOR: 0.538 and 0.604 at 1-year in Tertiary and Secondary groups). Advanced treatments like PCI, CABG, ECMO, EEG and therapeutic hypothermia were provided more in the higher level hospital. With regard to guideline change in 2010, there was a downturn in use of atropine and an increment in post-resuscitation care treatments in Tertiary and Secondary groups. Conclusions: Significant variability in cardiac arrest mortality exists across hospital levels, and this variation persists despite adjustment for measured patient factors. These findings suggest that higher level hospital provided more advanced procedures and post-resuscitation care, which leaded to higher hospital cost especially in acute period, and showed good adherence to guideline updates. (NRF-2017R1A2B100 5037)

scholarly journals Penerapan Kompres Hangat Terhadap Penurunan Suhu Tubuh Anak Demam Usia Pra-Sekolah

2021 ◽  
Vol 1 ◽  
pp. 1627-1632
Author(s):  
Lia Lutfita Santi ◽  
Siti Rofiqoh ◽  
Windha Widyastuti
Keyword(s):  
Body Temperature ◽  
Normal Limit ◽  
Preschool Age ◽  
Warm Water ◽  
Lower Body ◽  
Lower Body Temperature ◽  
Preschool Age Children ◽  
Preschool Aged Children

AbstractFever is a condition where body temperature exceeds normal limit, caused by an increase in the temperature-regulating center in the hypothalamus. Warm compress is an easy way to lower body temperature. This type of compress involves a clean cloth soaked in warm water, which is applied to the skin. The purpose of this case study is to evaluate a warm compress method in reducing fever. Two preschool-aged children with fever were treated by warm compresses. The results of this case study showed that the first and second patients experienced a decrease in body temperature after warm compresses. Body temperature for the first patient was 39ºC and dropped to normal (37ºC). meanwhile, the second patient temperature was 38,7ºC dropped to 36,5ºC. The conclusion of this study is warm compress can reduce body temperature in children with fever. Nurses or patients may be albe to apply warm compresses as a first ald in reducing fever.Keywords: Preschool Age Children, Fever, Warm Compress AbstrakDemam adalah kondisi suhu tubuh melebihi batas normal yang diakibatkan oleh meningkatnya pusat pengatur suhu di hipotalamus. Salah satu tindakan untuk menurunkan suhu tubuh anak yaitu dengan kompres hangat. Kompres adalah pemeliharaan suhu tubuh dengan menggunakan cairan atau alat yang dapat menimbulkan hangat atau dingin pada bagian tubuh. Tujuan dilakukan penerapan ini untuk mengambarkan penerapan kompres hangat terhadap penurunan suhu tubuh anak demam usia prasekolah. Metode yang digunakan dalam studi kasus ini adalah penelitian deskriptif dengan subyek dua pasien anak usia prasekolah yang mengalami demam. Hasil dari studi kasus ini menunjukan bahwa klien pertama dan kedua mengalami penurunan suhu tubuh setelah dilakukan kompres hangat, pada kasus 1 suhu awal 39ºC setelah dilakukan kompres hangat suhu menjadi 37,1ºC, sedangkan pada kasus 2 dengan suhu awal 38,7ºC setelah dilakukan kompres hangat suhu menjadi 36,5ºC. Kesimpulannya adalah pemberian kompres hangat dapat menurunkan suhu tubuh pada anak dengan demam. Saran bagi perawat dan orangtua untuk dapat menerapkan kompres hangat sebagai alternatif menurunkan suhu tubuh anak dengan demam.Kata kunci: Anak Usia Prasekolah, Demam, Kompres Hangat

scholarly journals Prevalence and Predictors of Obesity among 7- to 17-Year-Old Schoolchildren in Urban Arusha, Tanzania

2019 ◽  
Vol 2019 ◽  
pp. 1-11 ◽  
Author(s):  
Haji Chomba ◽  
Haikael D. Martin ◽  
Judith Kimywe
Keyword(s):  
Logistic Regression ◽  
Childhood Obesity ◽  
Population Level ◽  
Overweight And Obesity ◽  
Multiple Logistic Regression ◽  
Eating Habit ◽  
Cross Sectional ◽  
Sleeping Time ◽  
Age And Sex ◽  
Predictor Factors

Background. Childhood obesity is currently increasing at an alarming rate worldwide. Childhood obesity research has not been reported in urban Arusha before. This is therefore the first study to investigate the prevalence and predictors of childhood obesity in urban Arusha. Methods. A cross-sectional study was conducted involving 451 schoolchildren. Overweight was defined to range from 85th to 94th BMI percentile for age and sex while obesity was defined as above 94th BMI percentile for age and sex. Chi-square test was used for comparison between child sex and sociobehaviors, and multiple logistic regression was used to determine the significant predictor factors at P values = 0.05. Results. The overall prevalence of overweight and obesity was 17.7% (80/451) with 12.6% (57/451) being obese and 5.1% (23/451) being overweight. Results from univariate logistic regression showed child sex, random sleeping time, and random eating habit were the significant predictor factors. However, when all the predictor factors were used in the final multiple logistic regression model, only random sleeping time and random eating habit of different food items irrespective of their nature were significant at P=0.000, AOR = 4.47, and 95% CI = 2.00–10.01, and P=0.012, AOR = 2.54, and 95% CI = 1.23–5.33, respectively. Conclusions. The prevalence of obesity was as higher as twice the prevalence observed in other previous studies in Tanzania. Being a girl, random sleeping time and random eating habit were independent predictors. In addition to larger sample sizes, longitudinal studies are needed in order to track individuals and population level trends in BMI over time.

The effect of extracorporeal cardiopulmonary resuscitation in re-arrest after survival event: a retrospective analysis

Perfusion ◽  
2019 ◽  
Vol 35 (1) ◽  
pp. 39-47
Author(s):  
Kap Su Han ◽  
Su Jin Kim ◽  
Eui Jung Lee ◽  
Sung Woo Lee
Keyword(s):  
Logistic Regression ◽  
Cardiac Arrest ◽  
Cardiopulmonary Resuscitation ◽  
Retrospective Analysis ◽  
Life Support ◽  
Advanced Cardiac Life Support ◽  
Alternative Methods ◽  
Multiple Logistic Regression ◽  
Extracorporeal Cardiopulmonary Resuscitation ◽  
Hospital Cardiac Arrest

Background: The objectives of this study were to 1) identify the risk factors for predicting re-arrest and 2) determine whether extracorporeal cardiopulmonary resuscitation results in better outcomes than conventional cardiopulmonary resuscitation for managing re-arrest in out-of-hospital cardiac arrest patients. Methods: This retrospective analysis was based on a prospective cohort. We included adult patients with non-traumatic out-of-hospital cardiac arrest who achieved a survival event. The primary measurement was re-arrest, defined as recurrent cardiac arrest within 24 hours after survival event. Multiple logistic regression analysis was used to predict re-arrest. Subgroup analysis was performed to evaluate the effect of extracorporeal cardiopulmonary resuscitation on the survival to discharge in out-of-hospital cardiac arrest patients who experienced re-arrest. Results: Of 534 patients suitable for inclusion, 203 (38.0%) were enrolled in the re-arrest group. Old age, prolonged advanced cardiac life support duration and the presence of hypotension at 0 hours after survival event were independent variables predicting re-arrest. In the re-arrest group, the extracorporeal cardiopulmonary resuscitation group (n = 25) showed better outcomes than the conventional cardiopulmonary resuscitation group. However, multiple logistic regression for predicting survival to discharge revealed that extracorporeal cardiopulmonary resuscitation was not an independent factor. Multiple logistic regression revealed that a hypotensive state at re-arrest was an independent risk factor for survival. Conclusion: Alternative methods that reduce the advanced cardiac life support duration should be considered to prevent re-arrest and attain good outcomes in out-of-hospital cardiac arrest patients. Extracorporeal cardiopulmonary resuscitation for re-arrest tended to show a good outcome compared to conventional cardiopulmonary resuscitation for re-arrest. Avoiding or immediately correcting hypotension may prevent re-arrest and improve the outcome of re-arrested patients.

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