OBJECTIVE: We sought to investigate the prognostic implication of early coagulopathy represented by initial DIC score in out-of-hospital cardiac arrest (OHCA). METHODS: OHCA registry was analyzed to identify patients with ROSC without recent use of anticoagulant between 2008 and 2011. Patients were assessed for prehosptial factors, initial laboratory results and therapeutic hypothermia. Outcome variables were survival discharge, 6-month CPC and survival duration within the first week after ROSC. Logistic regression and Cox proportional hazards models were used for both univariable and multivariable analysis. RESULTS: Among 273 eligible patients, initial DIC score was available in 252 (92.3%). Higher DIC score was associated with increased inhospital death (odds ratio [OR], 1.89 per unit; 95% confidence interval [CI], 1.48-2.41) and unfavorable long-term outcome (6-month CPC 3-5; OR, 2.21 per unit; 95% CI, 1.60-3.05). The adjusted ORs for both outcomes were 1.61 (95% CI, 1.17-2.22) and 1.84 (95% CI, 1.26-2.67), respectively. We categorized DIC score in five groups as <3, 3, 4, 5 and >5 and analyzed differential mortality risk using Cox proportional hazards model. Compared with reference group (DIC score<3), the adjusted HR for early mortality in each remaining group was 1.96 (95% CI, 1.13-3.40), 2.26 (95% CI, 1.27-4.02), 2.77 (95% CI, 1.58-4.85) and 4.29 (95% CI, 2.22-8.30), respectively (p-trend<0.001). The area under the receiver operating characteristic of DIC score for prediction of unfavorable long-term outcome was 0.79 (95% CI, 0.69-0.88). CONCLUSION: Increased initial DIC score in OHCA was an independent predictor for poor outcomes and early mortality risk.
OBJECTIVE: We sought to investigate the prognostic implication of early coagulopathy represented by initial DIC score in out-of-hospital cardiac arrest (OHCA). METHODS: OHCA registry was analyzed to identify patients with ROSC without recent use of anticoagulant between 2008 and 2011. Patients were assessed for prehosptial factors, initial laboratory results and therapeutic hypothermia. Outcome variables were survival discharge, 6-month CPC and survival duration within the first week after ROSC. Logistic regression and Cox proportional hazards models were used for both univariable and multivariable analysis. RESULTS: Among 273 eligible patients, initial DIC score was available in 252 (92.3%). Higher DIC score was associated with increased inhospital death (odds ratio [OR], 1.89 per unit; 95% confidence interval [CI], 1.48-2.41) and unfavorable long-term outcome (6-month CPC 3-5; OR, 2.21 per unit; 95% CI, 1.60-3.05). The adjusted ORs for both outcomes were 1.61 (95% CI, 1.17-2.22) and 1.84 (95% CI, 1.26-2.67), respectively. We categorized DIC score in five groups as <3, 3, 4, 5 and >5 and analyzed differential mortality risk using Cox proportional hazards model. Compared with reference group (DIC score<3), the adjusted HR for early mortality in each remaining group was 1.96 (95% CI, 1.13-3.40), 2.26 (95% CI, 1.27-4.02), 2.77 (95% CI, 1.58-4.85) and 4.29 (95% CI, 2.22-8.30), respectively (p-trend<0.001). The area under the receiver operating characteristic of DIC score for prediction of unfavorable long-term outcome was 0.79 (95% CI, 0.69-0.88). CONCLUSION: Increased initial DIC score in OHCA was an independent predictor for poor outcomes and early mortality risk.
Authors: Giuseppe Ristagno; Roberto Latini; Mario Plebani; Martina Zaninotto; Jukka Vaahersalo; Serge Masson; Marjaana Tiainen; Jouni Kurola; Flavio Gaspari; Valentina Milani; Ville Pettilä; Markus Benedikt Skrifvars Journal: Crit Care Date: 2015-03-31 Impact factor: 9.097
Authors: Sisse Rye Ostrowski; Nicolai Haase; Rasmus Beier Müller; Morten Hylander Møller; Frank Christian Pott; Anders Perner; Pär Ingemar Johansson Journal: Crit Care Date: 2015-04-24 Impact factor: 9.097
Authors: Ho Young Yune; Sung Phil Chung; Yoo Seok Park; Hyun Soo Chung; Hye Sun Lee; Jong Wook Lee; Jong Woo Park; Je Sung You; Incheol Park; Hahn Shick Lee Journal: PLoS One Date: 2015-03-23 Impact factor: 3.240
Authors: Michael Schwameis; Andreas Schober; Christian Schörgenhofer; Wolfgang Reinhard Sperr; Herbert Schöchl; Karin Janata-Schwatczek; Erol Istepan Kürkciyan; Fritz Sterz; Bernd Jilma Journal: Crit Care Med Date: 2015-11 Impact factor: 7.598