BACKGROUND: Following successful resuscitation from cardiac arrest, a prothrombotic state may contribute to end-organ dysfunction. We examined whether the level of serum thrombin-antithrombin (TAT) in patients hospitalized after cardiac arrest was associated with survival or the development of multiple organ failure (MOF). METHODOLOGY: A prospective cohort study of subjects with in-hospital cardiac arrest (IHCA) or out-of-hospital cardiac arrest (OHCA) treated between 1/1/2007 and 5/30/2010 at a single tertiary care referral center. TAT levels were measured at hospital arrival and 24h after cardiac arrest. Logistic regression was used to determine associations between TAT levels and survival and development of MOF. RESULTS: Data were available for 86 subjects. TAT levels decreased over time. Initial TAT levels (OR 0.03; 95%CI 0.001, 0.62) and category of illness severity (OR 0.39; 95% CI 0.21, 0.73) were associated with survival. Male gender (OR 3.86; 95% CI 1.17, 12.75) and category of illness severity (OR 1.86; 95% CI 1.09, 3.20), but not TAT levels were associated with development of MOF. Neither the 24-h TAT level, nor the change in TAT from initial to 24h was associated with survival when adjusted for category of illness severity. CONCLUSIONS: Initial serum TAT levels and category of illness severity are associated with survival. TAT levels are not associated with development of MOF. Initial TAT levels may be a useful prognostic adjunct in the post arrest population.
BACKGROUND: Following successful resuscitation from cardiac arrest, a prothrombotic state may contribute to end-organ dysfunction. We examined whether the level of serum thrombin-antithrombin (TAT) in patients hospitalized after cardiac arrest was associated with survival or the development of multiple organ failure (MOF). METHODOLOGY: A prospective cohort study of subjects with in-hospital cardiac arrest (IHCA) or out-of-hospital cardiac arrest (OHCA) treated between 1/1/2007 and 5/30/2010 at a single tertiary care referral center. TAT levels were measured at hospital arrival and 24h after cardiac arrest. Logistic regression was used to determine associations between TAT levels and survival and development of MOF. RESULTS: Data were available for 86 subjects. TAT levels decreased over time. Initial TAT levels (OR 0.03; 95%CI 0.001, 0.62) and category of illness severity (OR 0.39; 95% CI 0.21, 0.73) were associated with survival. Male gender (OR 3.86; 95% CI 1.17, 12.75) and category of illness severity (OR 1.86; 95% CI 1.09, 3.20), but not TAT levels were associated with development of MOF. Neither the 24-h TAT level, nor the change in TAT from initial to 24h was associated with survival when adjusted for category of illness severity. CONCLUSIONS: Initial serum TAT levels and category of illness severity are associated with survival. TAT levels are not associated with development of MOF. Initial TAT levels may be a useful prognostic adjunct in the post arrest population.
Authors: Jon C Rittenberger; Samuel A Tisherman; Margo B Holm; Francis X Guyette; Clifton W Callaway Journal: Resuscitation Date: 2011-07-05 Impact factor: 5.262
Authors: Graham Nichol; Elizabeth Thomas; Clifton W Callaway; Jerris Hedges; Judy L Powell; Tom P Aufderheide; Tom Rea; Robert Lowe; Todd Brown; John Dreyer; Dan Davis; Ahamed Idris; Ian Stiell Journal: JAMA Date: 2008-09-24 Impact factor: 56.272
Authors: P Chamouard; L Grunebaum; M L Wiesel; P L Frey; C Wittersheim; R Sapin; R Baumann; J P Cazenave Journal: Eur J Gastroenterol Hepatol Date: 1995-12 Impact factor: 2.566
Authors: Wayne Rosamond; Katherine Flegal; Karen Furie; Alan Go; Kurt Greenlund; Nancy Haase; Susan M Hailpern; Michael Ho; Virginia Howard; Brett Kissela; Bret Kissela; Steven Kittner; Donald Lloyd-Jones; Mary McDermott; James Meigs; Claudia Moy; Graham Nichol; Christopher O'Donnell; Veronique Roger; Paul Sorlie; Julia Steinberger; Thomas Thom; Matt Wilson; Yuling Hong Journal: Circulation Date: 2007-12-17 Impact factor: 29.690