Abstract 99: Estimated Regional Oxy-hemoglobin Concentration is an Excellent and Simple Predictor of Neurological Outcome for Post Cardiac Arrest Syndrome: A Prospective Multicenter Observational Study
Background: We previously reported that an regional cerebral oxygen saturation (rSO2) at hospital arrival can predict neurological outcomes in patients who suffered out-of-hospital cardiac arrest. In this post-hoc analyses, we investigated whether estimated regional oxy-Hb (erHbO2), the product of Hb and rSO2 which might represent regional tissue oxy-Hb existence theoretically, plays pivotal role in the development of neurological impairment in patients with post cardiac arrest patients (PCAS).
Methods & Results: From May 2011 through July 2012, 363 consecutive comatose survivors admitted to hospitals were analyzed in this study. The primary outcome measure was a neurological outcome at 90 days. Forty-five patients (12.4%) presented good neurological outcome. The receiver operating characteristic curve analyses revealed rSO2 cutoff of 40% and erHbO2 cutoff of 3.6 had the maximum joint sensitivity and specificity to predict a good neurological outcome (rSO2: AUCs, 0.831; 95%CI, 0.770-0.892; sensitivity, 84.4%; specificity, 76.1%. erHbO2: AUCs, 0.872; 95%CI, 0.821-0.923; sensitivity, 91.1%; specificity, 71.4%). In a subgroup of patients with rSO2 >40% of optimal cutoff (n=114, 38 [33.3%] patients with good outcome), multivariate analysis revealed that erHbO2 was a significant predictor of a good neurological outcome (Odds: 1.34, 95% CI; 1.04-1.71, p=0.02), such that a 1-point increase in erHbO2 is associated with approximately 35% increase in the odds for good neurological outcome.
Conclusion: Our results demonstrate that rSO2 and erHbO2 can predict good neurological outcome. erHbO2 may be a useful index for neuro-protection in patients with PCAS.
- © 2013 by American Heart Association, Inc.