Combination of hemoglobin and low-flow duration can predict neurological outcome in the initial phase of out-of-hospital cardiac arrest.
Journal of Critical Care · 2018-08-07 · Observational study
Abstract
PURPOSE: To predict neurological outcome following out-of-hospital cardiac arrest (OHCA) using a combination of hemoglobin (Hb) and low-flow duration (LFD). MATERIALS AND METHODS: We retrospectively examined 131 patients (75 ± 13 years, 64 men) with return of spontaneous circulation (ROSC) following non-traumatic OHCA. The LFD was the duration from the start of cardiopulmonary resuscitation to ROSC. To obtain the Hb/LFD value, we divided the Hb level by the LFD. Multivariate logistic regression analyses were performed to predict full neurological recovery (FNR), defined as Cerebral Performance Category scale scores of 1 or 2 at discharge. RESULTS: Nineteen patients (15%) achieved FNR. Patients with FNR had high Hb levels (14.9 ± 2.1 vs. 11.3 ± 2.7 g/dl, p = 0.001) and short LFDs (10 [5, 18] vs. 35 [28, 43] min, p = 0.001). Multivariate analyses identified the initial ventricular fibrillation rhythm and Hb/LFD as significant predictors for FNR (odds ratio: 24.9, 3.58; p = 0.001, 0.02, respectively). Receiver operating characteristic (ROC) curve analyses indicated that a high Hb/LFD predicted FNR (cut-off value: 0.50, sensitivity: 94.7%, specificity: 84.5%, area under the curve: 0.933). CONCLUSIONS: Patients with FNR following OHCA had high Hb levels and short LFDs; the Hb/LFD value significantly predicted FNR.
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Decision support tools · Mortality & survival · Time intervals