Abstract 10842: Early Lactate Clearance is Associated With Intermediate-term Survival and Neurological Outcome in Patients With Post Cardiac Arrest Syndrome: SOS-KANTO 2012 Study Interim Report
Background: Lactate clearance (LC), a surrogate for the magnitude and duration of global tissue hypoxia, is used diagnostically, prognostically and therapeutically. We investigated the association of early lactate clearance with intermediate-term survival and neurological outcome in patients with post cardiac arrest syndrome (PCAS).
Methods: Data were collected from SOS-KANTO 2012 study database which is a prospective multicenter observational study including 6,019 OHCA. From Jan. 2012 to Oct. 2012, consecutive survivors admitted to hospitals were enrolled after excluding patients with requiring any assistance to complete activities of daily living before admission. The primary outcomes were a survival and a neurological outcome at 90 days. LC was defined as the percent change after 6 hours from hospital admission.
Result: One-hundred and ninety-five patients, age 63.4±17.3 years, were examined, with an overall LC of 35.2±82.3%, 90-day survival of 25.6% and good neurological outcome of 15.9%. Patients were divided into four quartiles of LC, -40.6±135.6, 38.1±9.0, 61.8±5.5 and 82.4±5.5, respectively (p<0.001). Kaplan-Meier survival analysis showed a survival benefit over 90 days in the higher LC quartiles (log rank, p<0.001). Receiver operating curve analysis indicated an optimal LC cutoff point of 70% for predicting good neurological outcome (AUCs 0.735, 95%CI 0.642-0.828, sensitivity 64.5%, specificity 78.7%). There was a significant increased proportion 90-day survival and good neurological outcome in the higher LC quartiles (chi squared test; p<0.001, Figure).
Conclusion: Early LC is significantly associated with increased proportion of intermediate-term survival and good neurological outcome in patients with PCAS.
- Post cardiac arrest care
- Post cardiac resuscitation
- Cardiopulmonary resuscitation
- Cardiac arrest
- © 2013 by American Heart Association, Inc.