Abstract P30: Relationship Between Hemoglobin Level on Hospital Arrival and Neurological Outcome in Cardiac Arrest Patients
OBJECTIVE: Hemoglobin is an important determinant of oxygen delivery during resuscitation. Previous studies have reported the association between reduced hemoglobin level and high mortality in patients with cardiovascular diseases. However, the relationship between hemoglobin values during resuscitation and neurological outcome has yet been elucidated. The aim of this study was to investigate whether hemoglobin level affects neurological outcome in cardiac arrest patients.
METHODS: From the SOS-KANTO Study Database (retrospective multicenter observational study using Utstein templates), 123 witnessed out-of-hospital cardiac arrest patients with presumed cardiac origin with bystander CPR were extracted (Male 88 patients, median age 62 y/o). Of those, 113 patients met following inclusion criteria; age: 12 to 84 y/o, body temperature on hospital arrival: 34.0 to 37.9 °C, hemoglobin level on arrival: 6.0 to 17.9 g/dl. Based on neurological outcomes 30 days after cardiac arrest, patients were divided into the favorable (Glasgow - Pittsburgh Cerebral-Performance Category: CPC>3) and unfavorable CPC group (CPC≤3), and Logistic regression analysis with backward elimination method was performed.
RESULTS: Of the 113 patients, 28 patients (24.8%, 21 male, median age 54 y/o) were classified into the favorable CPC group. Hemoglobin level was significantly higher in the favorable group than in the unfavorable group (median 15.1g/dl, 12.6g/dl, respectively, p<0.001). The multivariate analysis revealed hemoglobin level on arrival (Odds ratio [OR]=1.92, 95% confidence interval [CI]:1.15~3.22), body temperature on their hospital arrival (OR=3.81, CI:1.13–12.8), total amount of epinephrine (OR=0.001, CI:0.001– 0.057), and age (OR=0.80, CI:0.68 – 0.95) as independent predictors for favorable CPC.
CONCLUSIONS: Higher hemoglobin level is related to the favorable neurological outcomes in patients with cardiac arrest after resuscitation. This study suggests that hemoglobin contribute to delivering oxygen and may protect against reperfusion injury in brain during and after resuscitation.