The association between hemoglobin concentration and neurologic outcome after cardiac arrest.

Authors

Nicholas J. Johnson, University of Washington, Seattle
Babette Rosselot, OhioHealth
Sarah M. Perman, University of Colorado
Kalani Dodampahala, Drexel University
Munish Goyal, Medstar-Washington Hospital Center
David F. Gaieski, Thomas Jefferson UniversityFollow
Anne V. Grossestreuer, University of Pennsylvania

Document Type

Article

Publication Date

12-1-2016

Comments

This article is the authors' final version prior to publication in Journal of Critical Care, Volume 36, December 2016, Pages 218-222.

The published version is available at https://doi.org/10.1016/j.jcrc.2016.07.012. Copyright © Johnson et al.

Abstract

PURPOSE: The purpose of the study is to determine the association between hemoglobin concentration (Hgb) and neurologic outcome in postarrest patients.

METHODS: We conducted a retrospective cohort study using the Penn Alliance for Therapeutic Hypothermia (PATH) cardiac arrest registry. Inclusion criteria were resuscitated cardiac arrest (inhospital or out of hospital) and an Hgb value recorded within 24 hours of return of spontaneous circulation. The primary outcome was favorable neurologic status at hospital discharge. Survival to hospital discharge was a secondary outcome.

RESULTS: There were 598 eligible patients from 21 hospitals. Patients with favorable neurologic outcome had significantly higher median Hgb in the first 2 hours (12.7 vs 10.5 g/dL; P < .001) and 6 hours (12.6 vs 10.6 g/dL; P < .001) postarrest. Controlling for age, pulseless rhythm, etiology, location of arrest, receipt of targeted temperature management, hematologic or metastatic malignancy, or preexisting renal insufficiency, there was a significant relationship between Hgb and neurologic outcome within the first 6 hours after arrest (odds ratio, 1.23; 95% confidence interval, 1.09-1.38) and survival to hospital discharge (odds ratio, 1.20; 95% confidence interval, 1.08-1.34).

CONCLUSION: Higher Hgb after cardiac arrest is associated with favorable neurologic outcome, particularly within the first 6 hours. It is unclear if this effect is due to impaired oxygen delivery or if Hgb is a marker for more severe illness.

Recommended Citation

Johnson, Nicholas J.; Rosselot, Babette; Perman, Sarah M.; Dodampahala, Kalani; Goyal, Munish; Gaieski, David F.; and Grossestreuer, Anne V., "The association between hemoglobin concentration and neurologic outcome after cardiac arrest." (2016). Department of Emergency Medicine Faculty Papers. Paper 113.
https://jdc.jefferson.edu/emfp/113

Creative Commons License

This work is licensed under a Creative Commons Attribution-Noncommercial-No Derivative Works 4.0 License.

PubMed ID

27546775

Language

English