Abstract 234: The Association Between Post--Cardiac Arrest Hemoglobin Levels and Neurological Outcome
Background: Inadequate cerebral oxygenation is a risk factor for neurologic damage in successfully resuscitated cardiac arrest patients. One therapy to address this problem is early goal-directed hemodynamic optimization. However, the role of hemoglobin (Hgb) levels, a potential target for optimization, on outcomes in post-cardiac arrest patients is not known.
Objective: To determine the association between Hgb levels in post-cardiac arrest patients and neurologic outcome (dichotomized into “good,” a Cerebral Performance Category (CPC) of 1 or 2 and “poor,” a CPC of 3, 4, or 5, at hospital discharge). The association between Hgb levels and survival to discharge was analyzed as a secondary outcome.
Methods: A retrospective cohort study was conducted to compare patient demographics and Hgb levels. Hgb was analyzed as both a continuous and binary variable. To determine the association between Hgb levels and outcomes, multivariate logistic regression models controlling for gender, age, pulseless rhythm, and transfusion were used.
Results: There were 598 eligible subjects from 21 hospitals in the US. Patients with ≤10 g/dL of Hgb had a higher percentage of subjects with good neurologic outcome than those with Hgb levels below 10 g/dL (41% vs. 26%; p<0.001). Patients with good neurologic outcome had higher median Hgb levels in the first six hours after arrest than those with a poor neurologic outcome (12.6 g/dL vs. 10.5 g/dL; p<0.001). Controlling for gender, age, pulseless rhythm, and transfusion, there was a significant relationship between Hgb levels within the first six hours after arrest and good neurologic outcome (OR: 1.21, 95% CI: 1.06 [[Unable to Display Character: –]] 1.39) and the first 24 hours after arrest and good neurologic outcome (OR: 1.14, 95% CI: 1.01 [[Unable to Display Character: –]] 1.28). There was a significant association between Hgb levels within the first six hours after arrest and survival to discharge (OR: 1.22, 95% CI: 1.07 [[Unable to Display Character: –]] 1.39) and Hgb levels within the first 24 hours after arrest and survival to discharge (OR: 1.14, 95% CI: 1.02 [[Unable to Display Character: –]] 1.28).
Conclusions: Higher hemoglobin levels, particularly within the first six hours after cardiac arrest, are associated with better neurologic outcomes at hospital discharge in post-cardiac arrest patients admitted to the hospital.
Author Disclosures: B.R. Rosselot: None. A.V. Grossestreuer: Research Grant; Significant; American Heart Association. N.L. Lee: None. K. Dodampahala: None. M. Goyal: None. A. David: None. B.S. Abella: Research Grant; Significant; NIH, medtronic, stryker. Honoraria; Modest; velomedix, bard, heartsine. Ownership Interest; Modest; resuscor. D.F. Gaieski: Research Grant; Significant; Stryker. Honoraria; Modest; Bard. Honoraria; Significant; Stryker. Consultant/Advisory Board; Modest; Stryker.
- © 2014 by American Heart Association, Inc.