Association between hemoglobin levels and clinical outcomes in adult patients after in-hospital cardiac arrest

a retrospective cohort study

Chih Hung Wang, Chien Hua Huang, Wei Tien Chang, Min Shan Tsai, Ping Hsun Yu, An Yi Wang, Nai Chuan Chen, Wen Jone Chen

Research output: Contribution to journalArticle

5 Citations (Scopus)

Abstract

In addition to cardiac output, oxygen delivery is determined by the amount of oxygen carried by hemoglobin, which is estimated by the product of hemoglobin level and peripheral hemoglobin oxygen saturation (SpO2). Optimal hemoglobin concentration for post-cardiac arrest syndrome (PCAS) has not yet been investigated thoroughly. We conducted a retrospective observational study in a single medical center. We included adult patients between 2006 and 2012 who experienced in-hospital cardiac arrest, and achieved sustained return of spontaneous circulation (ROSC). We used multivariable logistic regression analysis to identify factors associated with favorable neurological status at hospital discharge, defined as a score of 1 or 2 on the Cerebral Performance Category scale. Minimum hemoglobin concentration and SpO2 during the initial 24 h after ROSC were used for analysis. Anemia was defined by the World Health Organization criteria as a hemoglobin concentration <12 g/dL in women and <13 g/dL in men. Of the 426 patients included in our analysis, 387 patients (90.8 %) met the criteria for anemia. The mean minimum hemoglobin concentration among all the patients was 9.2 g/dL. The product of hemoglobin × SpO2 was correlated with a favorable neurological outcome (odds ratio 1.003, 95 % confidence interval 1.002–1.004). According to recommended SpO2 by resuscitation guidelines (94–98 %), we calculated the corresponding range of minimum required hemoglobin concentration to be 8.6–9.0 g/dL for a favorable neurological outcome. Anemia common among PCAS patients. Neurological outcome in PCAS might be correlated with hemoglobin concentration following resuscitation.

Original languageEnglish
Pages (from-to)727-736
Number of pages10
JournalInternal and Emergency Medicine
Volume11
Issue number5
DOIs
Publication statusPublished - Aug 1 2016
Externally publishedYes

Fingerprint

Heart Arrest
Hemoglobins
Cohort Studies
Retrospective Studies
Anemia
Oxygen
Resuscitation
Cardiac Output
Observational Studies
Logistic Models
Odds Ratio
Regression Analysis
Guidelines
Confidence Intervals

Keywords

  • Cardiopulmonary resuscitation
  • Critical care
  • Emergency medicine
  • Heart arrest
  • Hemoglobin
  • Oxygen

ASJC Scopus subject areas

  • Internal Medicine
  • Emergency Medicine

Cite this

Association between hemoglobin levels and clinical outcomes in adult patients after in-hospital cardiac arrest : a retrospective cohort study. / Wang, Chih Hung; Huang, Chien Hua; Chang, Wei Tien; Tsai, Min Shan; Yu, Ping Hsun; Wang, An Yi; Chen, Nai Chuan; Chen, Wen Jone.

In: Internal and Emergency Medicine, Vol. 11, No. 5, 01.08.2016, p. 727-736.

Research output: Contribution to journalArticle

Wang, Chih Hung ; Huang, Chien Hua ; Chang, Wei Tien ; Tsai, Min Shan ; Yu, Ping Hsun ; Wang, An Yi ; Chen, Nai Chuan ; Chen, Wen Jone. / Association between hemoglobin levels and clinical outcomes in adult patients after in-hospital cardiac arrest : a retrospective cohort study. In: Internal and Emergency Medicine. 2016 ; Vol. 11, No. 5. pp. 727-736.
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