Chih-Jung Chang1, Tse-Hsuan Liou2, Wei-Ting Tsai2, Ching-Fang Hsu2, Wah-Sheng Chong1, Jen-Tang Sun1,3, Tzung-Hai Yen4,5,6, Wen-Chu Chiang7,8, Chih-Chun Chang2,9. 1. Far Eastern Memorial Hospital Department of Emergency Medicine New Taipei City Taiwan. 2. Far Eastern Memorial Hospital Department of Clinical Pathology New Taipei City Taiwan. 3. National Yang Ming University Institute of Emergency and Critical Care Medicine Taipei Taiwan. 4. Chang Gung Memorial Hospital Department of Nephrology and Clinical Poison Center Linkou, Taoyuan Taiwan. 5. Kidney Research Center, Chang Gung Memorial Hospital Linkou, Taoyuan Taiwan. 6. Chang Gung University College of Medicine Taoyuan Taiwan. 7. National Taiwan University Hospital Department of Emergency Medicine Taipei Taiwan. 8. National Taiwan University Hospital Department of Emergency Medicine Yun-Lin Branch, Yunlin Taiwan. 9. Cardinal Tien Junior College of Healthcare and Management Department of Nursing Yilan Taiwan.
Abstract
BACKGROUND: To investigate the association of clinical and hematological parameters with return of spontaneous circulation (ROSC) in out-of-hospital cardiac arrest (OHCA). METHODS: Clinical data of successive non-traumatic adult OHCA patients with available laboratory data of complete blood count and peripheral blood smear at emergency department (ED) arrival were requested. Hematological parameters were collected and calculated, and logistic regression and survival analysis were performed for association of ROSC with the parameters. RESULTS: From December 2015 to December 2016, a total of 188 OHCA patients transported to our ED were enrolled. In ROSC group, neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR) were signifi cantly higher and smudge cell count was signifi cantly lower when compared with non-ROSC group. In the univariate regression, NLR more than 2.0 (odds ratio [OR]: 2.40, 95% confi dence interval [CI]: 1.31-4.41; p = 0.004) and smudge cell count less than 0.45 °- 109/L (OR: 0.33, 95% CI: 0.15-0.71; p = 0.004) were signifi cantly associated with ROSC in OHCA. In logistic regression, bystander witnessed (OR: 3.15, 95% CI: 1.59-6.27; p = 0.001) and prehospital epinephrine use (OR: 2.15, 95% CI: 1.10-4.23; p = 0.026) were signifi cantly associated with ROSC in OHCA. NLR and smudge cell count were also seemingly related to ROSC in OHCA, but without statistical signifi cance. In survival analysis, neither NLR nor smudge cell count was associated with patient survival to discharge in OHCA. CONCLUSIONS: NLR and smudge cell count at ED arrival could be potential indicators of ROSC in OHCA.
BACKGROUND: To investigate the association of clinical and hematological parameters with return of spontaneous circulation (ROSC) in out-of-hospital cardiac arrest (OHCA). METHODS: Clinical data of successive non-traumatic adult OHCA patients with available laboratory data of complete blood count and peripheral blood smear at emergency department (ED) arrival were requested. Hematological parameters were collected and calculated, and logistic regression and survival analysis were performed for association of ROSC with the parameters. RESULTS: From December 2015 to December 2016, a total of 188 OHCA patients transported to our ED were enrolled. In ROSC group, neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR) were signifi cantly higher and smudge cell count was signifi cantly lower when compared with non-ROSC group. In the univariate regression, NLR more than 2.0 (odds ratio [OR]: 2.40, 95% confi dence interval [CI]: 1.31-4.41; p = 0.004) and smudge cell count less than 0.45 °- 109/L (OR: 0.33, 95% CI: 0.15-0.71; p = 0.004) were signifi cantly associated with ROSC in OHCA. In logistic regression, bystander witnessed (OR: 3.15, 95% CI: 1.59-6.27; p = 0.001) and prehospital epinephrine use (OR: 2.15, 95% CI: 1.10-4.23; p = 0.026) were signifi cantly associated with ROSC in OHCA. NLR and smudge cell count were also seemingly related to ROSC in OHCA, but without statistical signifi cance. In survival analysis, neither NLR nor smudge cell count was associated with patient survival to discharge in OHCA. CONCLUSIONS: NLR and smudge cell count at ED arrival could be potential indicators of ROSC in OHCA.
Authors: Robert B Dunne; Scott Compton; R J Zalenski; Robert Swor; Robert Welch; Brooks F Bock Journal: Resuscitation Date: 2006-11-17 Impact factor: 5.262
Authors: Christoph Weiser; Michael Schwameis; Fritz Sterz; Harald Herkner; Irene M Lang; Ilse Schwarzinger; Alexander O Spiel Journal: Resuscitation Date: 2017-05-02 Impact factor: 5.262