Abstract 260: Relationship Between the Blood Hemoglobin Level at Hospital Arrival and Post--Cardiac Arrest Neurological Outcome
Recent studies have revealed that regional brain oxygen saturation (rSO2) is an excellent predictor for a neurological outcome in OHCA. It also has been suggested that brain tissue oxygenation is crucial for a post cardiac arrest syndrome (PCAS). Hemoglobin (Hb) is an indispensable for oxygen delivery to peripheral tissue. Therefore, it is considered that Hb plays an important role in PCAS. In the present study, we aim to elucidate the relationship between blood Hb level and the neurological outcome in PCAS.
The database of the J-POP registry (multicenter observational study) has prospectively enrolled 764 OHCA patients. Of these, 193 PCAS patients admitted to the wards after ROSC were included in this study. Blood Hb level (median 12.0g/dL, [IQR 10.4-13.8]) and rSO2 (35%, [15-55]) were obtained during resuscitation within 3 min after hospital arrival. The neurological outcome was evaluated by CPC at 30 days, and CPC1 and 2 were defined as favorable neurologic outcome.
RESULTS: Among 193 PCAS patients, 27 showed favorable outcome (14%). There was no significant correlation between rSO2 and Hb level (P=0.43). Univariate analyses revealed that the favorable outcome group was characterized as younger, male, witnessed CA, initial shockable rhythm, higher Hb level, rSO2>35%, and shorter transport interval from the scene to the hospital. Coronary angiography (CAG) and therapeutic hypothermia were also associated with the favorable outcome. The multivariate analysis showed that rSO2>35% (OR 35.0 [7.5-163.4]), Hb (1.48 [1.08-2.01]), CAG (45.8 [7.7-271.1]) were independent predictors for the favorable outcome.
A higher blood Hb level was associated with a favorable short-term neurological outcome in patients with PCAS regardless of rSO2.
- © 2012 by American Heart Association, Inc.