Abstract 299: Relationship Between Renal Function and Neurological Outcome in Patients After Out-of-Hospital Cardiac Arrest: SOS-KANTO 2012 Study
BACKGROUND: Recent studies have indicated that renal dysfunction is the risk factor for sudden cardiac death. Even mild renal impairment has been identified as an important and independent cardiovascular risk factor. Increased vascular stiffness has a pivotal role in development of reduced coronary reserve and impaired contractility in patients with renal impairment. We hypothesized that the reduced coronary reserve in cardiac arrest patients due to renal dysfunction influences resuscitation outcomes.
OBJECTIVES: To elucidate the relationship between eGFR and resuscitation outcome in patients with out-of-hospital cardiac arrest (OHCA).
METHODS: The SOS-KANTO 2012 Study enrolled the 16,452 cardiac arrest registry in the Metropolitan area in Japan. In the registry, we identified 3,833 adult (≥18 y/o) witnessed OHCA patients with good activities of daily living. Of those, 1,522 were received bystander chest compressions. Of the 1,522, 704 had cardiac causes. Excluding patients with missing blood creatinine level, remaining 508 patients were studied in this study. Patients were classified into two groups according to their cerebral performance category (CPC) at 3 months after CA, favorable (CPC 1-2) and poor (CPC3-5) outcome groups. Data of age (mean±sd: 66±15 y/o), sex (386 male), response time (8.4±3.7 min), initial rhythm (177 VF/VT), blood hemoglobin level (12.5±7.4 g/dl), eGFR (46.5, 3.4 to 153), and CPC at 3 months (43 favorable) were collected.
RESULTS: The eGFR was significantly higher in the favorable outcome group than in poor outcome group (64.7±23.0, 43.8±19.9, t-test: P<0.001). A multivariate Logistic regression analysis with backward elimination method revealed that recognized VF/VT as the initial rhythm and eGFR are independent predictors for the favorable outcome (age and sex adjusted odds ratio=36.4 [95% confidence interval: 4.64 to 285], 1.05 [1.02 to 1.08], respectively).
CONCLUSIONS: Higher renal function was associated with a higher likelihood of favorable neurological outcome. Our findings suggested that resuscitation outcome is affected by cardio-renal interaction.
Author Disclosures: M. Suzuki: None. K. Hayashida: None. S. Hori: None. Y. Tahara: None. A. Sakurai: None. A. Yaguchi: None. N. Morimura: None. K. Nagao: None.
- © 2014 by American Heart Association, Inc.