Relationship between the hemoglobin level at hospital arrival and post-cardiac arrest neurologic outcome

Ken Nagao, Kimio Kikushima, Tetsuya Sakamoto, Kazuhide Koseki, Masaki Igarashi, Shinichi Ishimatsu, Akira Sato, Shingo Hori, Shigeru Kanesaka, Yuichi Hamabe, Daizo Saito, Shinya Kitamura

Research output: Contribution to journalArticle

20 Citations (Scopus)

Abstract

Background: The hemoglobin (Hb) level is an essential determinant of oxygen delivery. The restoration of blood perfusion to vital organs and the capacity for oxygen delivery may be associated with ischemia and reperfusion injuries during cardiac arrest and after cardiac arrest. However, whether the Hb level is associated with neurologic outcome in post-cardiac arrest patients remains unclear. Methods: Emergency medical service information and clinical demographics were compiled for witnessed out-of-hospital cardiac arrest patients with coma after the restoration of spontaneous circulation. The study end point was defined as a favorable neurologic outcome at 28 days. We evaluated the relationship between the Hb level at the time of hospital arrival and the neurologic outcome using univariate analyses and a multivariate logistic regression analysis. Results: There were 137 witnessed cardiac arrest patients: 49 (35.7%) survived and 34 (24.8%) achieved a favorable neurologic outcome. Univariate analyses showed that the favorable outcome group was characterized as having a higher Hb level, a younger age, a higher percentage of male patients, and ventricular fibrillation as the initial cardiac rhythm. In a multivariate analysis adjusting for potential confounding factors, the Hb level at the time of hospital arrival (odds ratio, 1.26; 95% confidence interval, 1.00-1.58) was an independent predictor of a favorable neurologic outcome. Conclusion: A higher Hb level at the time of hospital arrival was associated with a favorable short-term neurologic outcome among post-cardiac arrest patients with a presumed cardiac etiology.

Original languageEnglish
Pages (from-to)770-774
Number of pages5
JournalAmerican Journal of Emergency Medicine
Volume30
Issue number5
DOIs
Publication statusPublished - 2012 Jun
Externally publishedYes

ASJC Scopus subject areas

  • Emergency Medicine

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    Nagao, K., Kikushima, K., Sakamoto, T., Koseki, K., Igarashi, M., Ishimatsu, S., Sato, A., Hori, S., Kanesaka, S., Hamabe, Y., Saito, D., & Kitamura, S. (2012). Relationship between the hemoglobin level at hospital arrival and post-cardiac arrest neurologic outcome. American Journal of Emergency Medicine, 30(5), 770-774. https://doi.org/10.1016/j.ajem.2011.03.031