The Association between Disseminated Intravascular Coagulation Profiles and Neurologic Outcome in Patients with In-Hospital Cardiac Arrest.

Autor:	Lee DH; Department of Emergency Medicine, Chonnam National University Hospital, 61469 Gwangju, Republic of Korea.; Department of Emergency Medicine, Chonnam National University Medical School, 61469 Gwangju, Republic of Korea., Lee BK; Department of Emergency Medicine, Chonnam National University Hospital, 61469 Gwangju, Republic of Korea.; Department of Emergency Medicine, Chonnam National University Medical School, 61469 Gwangju, Republic of Korea., Ryu SJ; Department of Emergency Medicine, Chonnam National University Hospital, 61469 Gwangju, Republic of Korea., Lee JH; Department of Emergency Medicine, Chonnam National University Hospital, 61469 Gwangju, Republic of Korea., Bae SJ; Department of Emergency Medicine, Chung-Ang University Gwangmyeong Hospital, 14353 Gyeonggi-do, Republic of Korea., Choi YH; Department of Emergency Medicine, Chung-Ang University Gwangmyeong Hospital, 14353 Gyeonggi-do, Republic of Korea.
Jazyk:	angličtina
Zdroj:	Reviews in cardiovascular medicine [Rev Cardiovasc Med] 2024 Sep 23; Vol. 25 (9), pp. 340. Date of Electronic Publication: 2024 Sep 23 (Print Publication: 2024).
DOI:	10.31083/j.rcm2509340
Abstrakt:	Background: The relationship between disseminated intravascular coagulation (DIC) profiles and survival or neurological outcomes in out-of-hospital cardiac arrest (OHCA) patients is well known. In contrast, the relationship between DIC profiles and neurological outcomes in patients with in-hospital cardiac arrest (IHCA) remains unclear. This study sought to examine the correlation between DIC profiles and neurological outcomes in IHCA patients. Methods: A retrospective observational study was conducted on comatose adult IHCA patients treated with targeted temperature management between January 2017 and December 2022. DIC profiles were used to calculate the DIC score, and were measured immediately after the return of spontaneous circulation (ROSC). The primary endpoint was a poor neurological outcome at six months, defined by cerebral performance in categories 3, 4, or 5. Multivariate analysis was used to evaluate the association between DIC profiles and poor neurological outcomes. Results: The study included 136 patients, of which 107 (78.7%) patients demonstrated poor neurological outcomes. These patients had higher fibrinogen (3.2 g/L vs. 2.3 g/L) and fibrin degradation product levels (50.7 mg/L vs. 30.1 mg/L) and lower anti-thrombin III (ATIII) levels (65.7% vs. 82.3%). The DIC score did not differ between the good and poor outcome groups. In multivariable analysis, fibrinogen (odds ratio [OR], 1.009; 95% confidence intervals [CI], 1.003-1.016) and ATIII levels (OR, 0.965; 95% CI, 0.942-0.989) were independently associated with poor neurological outcomes. Conclusions: Decreased fibrinogen and ATIII levels after ROSC were an independent risk factor for unfavorable neurological outcomes in IHCA. The DIC score is unlikely to play a significant role in IHCA prognosis in contrast to OHCA. Competing Interests: The authors declare no conflict of interest. (Copyright: © 2024 The Author(s). Published by IMR Press.)
Databáze:	MEDLINE
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