Objective The objective of this study was to test the hypothesis that hemoglobin concentration after return of spontaneous circulation (ROSC) is associated with neurologic outcome after cardiac arrest in patients treated with targeted temperature management.
Methods We studied consecutive adult patients with out-of-hospital cardiac arrest treated with targeted temperature management between January 2009 and December 2015. We quantified the association between post ROSC hemoglobin concentrations and good neurologic outcome (defined as Cerebral Performance Category of 1 and 2) at hospital discharge using multivariate logistic regression analysis.
Results A total of 246 subjects were ultimately included in this study. The mean age was 54 years (standard deviation, 17); 168 (68%) subjects were male. Eighty-seven (35%) subjects had a good neurologic outcome at hospital discharge. Hemoglobin concentrations were higher in the good outcome group than in the poor outcome group (14.4±2.0 vs. 12.8±2.5 g/dL, P<0.001). Multivariate logistic regression analysis showed that hemoglobin concentrations were associated with good neurologic outcome at hospital discharge after adjusting for other confounding factors (adjusted odds ratio, 1.186; 95% confidence interval, 1.008 to 1.395).
Conclusion These results show that hemoglobin concentrations after ROSC are associated with neurologic outcome at hospital discharge. Future research to examine the association between hemoglobin levels and neurologic outcome after cardiac arrest is warranted.
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Association between early red blood cell transfusion after return of spontaneous circulation and clinical outcomes in cardiac arrest patients Chae Hun Lee, Ju Hwan Choi, Sinyoung Kim, Incheol Park, Hyun Soo Chung, Soon Sung Kwon, Jinwoo Myung Scientific Reports.2026;[Epub] CrossRef
Critical Care Management of Patients After Cardiac Arrest: A Scientific Statement from the American Heart Association and Neurocritical Care Society Karen G. Hirsch, Benjamin S. Abella, Edilberto Amorim, Mary Kay Bader, Jeffrey F. Barletta, Katherine Berg, Clifton W. Callaway, Hans Friberg, Emily J. Gilmore, David M. Greer, Karl B. Kern, Sarah Livesay, Teresa L. May, Robert W. Neumar, Jerry P. Nolan, Neurocritical Care.2024; 40(1): 1. CrossRef
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Objective The objective of this study was to test the hypothesis that an elevated high-sensitivity C-reactive protein (hs-CRP)/albumin ratio at admission increases the risk of mortality in older patients admitted to the hospital via the emergency department (ED).
Methods We performed a retrospective analysis of patients admitted to the ED with any medical problem between May 2013 and October 2013 who were older than 65 years. The hs-CRP and albumin levels were measured at the time of admission to the ED. The primary outcome was all-cause in-hospital mortality. Multivariate logistic analysis was performed.
Results A total of 811 patients were finally included in this study. The mean age was 76±7 years, and 438 subjects (54%) were male. The in-hospital mortality rate was 9.0% (73 patients). The hs-CRP/albumin ratio was higher in nonsurvivors than in survivors (34.2±37.6 vs. 16.2±25.5, P<0.001). Multivariate logistic analysis showed that the hs-CRP/albumin ratio was associated with all-cause in-hospital mortality after adjusting for other confounding factors (odds ratio, 1.011; 95% confidence interval [CI], 1.003 to 1.020). The prognostic value of the hs-CRP/albumin ratio for predicting mortality (area under the curve, 0.728; 95% CI, 0.696 to 0.758) was greater than that of hs-CRP alone (area under the curve, 0.706; 95% CI, 0.674 to 0.738; P<0.001).
Conclusion The hs-CRP/albumin ratio at admission to the ED is associated with all-cause in-hospital mortality among patients older than 65 years. The hs-CRP/albumin ratio may serve as a surrogate marker of disease severity.
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