본문 바로가기
KERD
논문KCI 등재

Change in Red Cell Distribution Width as Predictor of Death and Neurologic Outcome in Patients Treated with Therapeutic Hypothermia after Out-of-Hospital Cardiac Arrest

김진주|이근|조진성|임용수|양혁준|김성탁
대한중환자의학회 (The Korean Society Of Critical Care Medicine)|2014.11|Acute and Critical Care|제29권 제4호|pp. 313-319

1

조회

0

다운로드

1

인용

0

참고문헌

키워드

mortalityprognosisout-of-hospital cardiac arresterythrocyte indices

초록

Background: The prognostic significance of change in red cell distribution width (RDW) during hospital stays in patients treated with therapeutic hypothermia (TH) after out-of-hospital cardiac arrest (OHCA) was investigated. Methods: Patients treated with TH after OHCA between January 2009 and August 2013 were reviewed. Patients with return of spontaneous circulation (ROSC) were assessed according to Utstein Style. Hematologic variables including RDW, hematocrit, white blood cell count, and platelets were also obtained. RDW changes during the 72 hours after ROSC were categorized into five groups as follows: Group 1 (-0.8-0.1%), Group 2 (0.2-0.3%), Group 3 (0.4-0.5%), Group 4 (0.6-0.8%), and Group 5 (>0.8%). Results: A total of 218 patients were enrolled in the study. RDW changes during the 72 hours after ROSC in Group 4 (HR 3.56, 95% CI 1.25-10.20) and Group 5 (HR 5.07, 95% CI 1.73-14.89) were associated with a statistically significant difference in one-month mortality. RDW changes were associated with statistically significant differences in neurologic outcome at 6 months after ROSC (Group 3 [HR 2.45, 95% CI 1.17-5.14], Group 4 [HR 2.79, 95% CI 1.33-5.84], Group 5 [HR 3.50, 95% CI 1.35-7.41]). Other significant variables were location of arrest, cause of arrest, serum albumin, and advanced cardiac life support time. Conclusions: RDW change during the 72 hours after ROSC is a predictor of mortality and neurologic outcome in patients treated with TH after OHCA.

Abstract

Background: The prognostic significance of change in red cell distribution width (RDW) during hospital stays in patients treated with therapeutic hypothermia (TH) after out-of-hospital cardiac arrest (OHCA) was investigated. Methods: Patients treated with TH after OHCA between January 2009 and August 2013 were reviewed. Patients with return of spontaneous circulation (ROSC) were assessed according to Utstein Style. Hematologic variables including RDW, hematocrit, white blood cell count, and platelets were also obtained. RDW changes during the 72 hours after ROSC were categorized into five groups as follows: Group 1 (-0.8-0.1%), Group 2 (0.2-0.3%), Group 3 (0.4-0.5%), Group 4 (0.6-0.8%), and Group 5 (>0.8%). Results: A total of 218 patients were enrolled in the study. RDW changes during the 72 hours after ROSC in Group 4 (HR 3.56, 95% CI 1.25-10.20) and Group 5 (HR 5.07, 95% CI 1.73-14.89) were associated with a statistically significant difference in one-month mortality. RDW changes were associated with statistically significant differences in neurologic outcome at 6 months after ROSC (Group 3 [HR 2.45, 95% CI 1.17-5.14], Group 4 [HR 2.79, 95% CI 1.33-5.84], Group 5 [HR 3.50, 95% CI 1.35-7.41]). Other significant variables were location of arrest, cause of arrest, serum albumin, and advanced cardiac life support time. Conclusions: RDW change during the 72 hours after ROSC is a predictor of mortality and neurologic outcome in patients treated with TH after OHCA.

참고문헌 (20)

  1. Go AS, "Heart disease and stroke statistics--2013update: a report from the American heart association", Circulation, 127, pp.e1~e240 (2013)
  2. Pell JP, "Presentation, management, and outcome of out of hospital cardiopulmonary arrest: comparison by underlying aetiology", Heart, 89, pp.839~842 (2003)
  3. Atwood C, "Incidence of EMS-treated out-of-hospital cardiac arrest in Europe", Resuscitation, 67, pp.75~80 (2005)
  4. (2012)[URL]
  5. Neumar RW, "Post-cardiac arrest syndrome: epidemiology, pathophysiology, treatment, and prognostication. A consensus statement from the International liaison committee on resuscitation (American heart association, Australian and New Zealand Council on resuscitation, European resuscitation council, heart and stroke foundation of Canada, InterAmerican heart foundation, resuscitation council of Asia, and the resuscitation council of Southern Africa); the American heart association emergency cardiovascular care committee; the council on cardiovascular surgery and anesthesia; the council on cardiopulmonary, perioperative, and critical care; the council on clinical cardiology; and the stroke council", Circulation, 118, pp.2452~2483 (2008)
  6. Peberdy MA, "Part 9: post-cardiac arrest care 2010 American heart association guidelines for cardiopulmonary resuscitation and emergency cardiovascular care", Circulation, 122, pp.S768~S786 (2010)
  7. Sasson C, "Predictors of survival from out-of-hospital cardiac arrest: a systematic review and meta-analysis", Circ Cardiovasc Qual Outcomes, 3, pp.63~81 (2010)
  8. Fugate JE, "Predictors of neurologic outcome in hypothermia after cardiac arrest", Ann Neurol, 68, pp.907~914 (2010)
  9. Sandroni C, "In-hospital cardiac arrest: incidence, prognosis and possible measures to improve survival", Intensive Care Med, 33, pp.237~245 (2007)
  10. Scolletta S, "Biomarkers as predictors of outcome after cardiac arrest", Expert Rev Clin Pharmacol, 5, pp.687~699 (2012)
  11. Morris M, "Basic examination of blood. In:Clinical diagnosis and management by laboratory methods", pp.544~545 (2001), W.B. Saunders Company
  12. Demir A, "Most reliable indices in differentiation between thalassemia and trait and iron deficiency anemia", Pediatr Int, 44, pp.612~616 (2002)
  13. Majercik S, "Red cell distribution width is predictive of mortality in trauma patients", J Trauma Acute Care Surg, 74, pp.1021~1026 (2013)
  14. Kim J, "Red blood cell distribution width as an independent predictor of all-cause mortality in out of hospital cardiac arrest", Resuscitation, 83, pp.1248~1252 (2012)
  15. Lee JH, "Red cell distribution width as a prognostic marker in patients with community-acquired pneumonia", Am J Emerg Med, 31, pp.72~79 (2013)
  16. Slaughter E, "Changes in red blood cell width distribution as a novel biomarker for bacteremia", Crit Care Med, 41, pp.A259~ (2013)
  17. (2013)[URL]
  18. Cavusoglu E, "Relation between red blood cell distribution width (RDW) and all-cause mortality at two years in an unselected population referred for coronary angiography", Int J Cardiol, 141, pp.141~146 (2010)
  19. Al-Najjar Y, "Red cell distribution width: an inexpensive and powerful prognostic marker in heart failure", Eur J Heart Fail, 11, pp.1155~1162 (2009)
  20. Chen PC, "Red blood cell distribution width and risk of cardiovascular events and mortality in a community cohort in Taiwan", Am J Epidemiol, 171, pp.214~220 (2010)

관련 논문AI추천

Thrombotic Microangiopathy Score as a New Predictor of Neurologic Outcomes in Patients after Out-of-Hospital Cardiac Arrest공태영, 유제성, 이종욱, 이혜선, 전소영, 정성필, 정현수연세대학교의과대학 · Yonsei Medical Journal2022 · 제63권 제5호Acute Physiologic and Chronic Health Examination II and Sequential Organ Failure Assessment Scores for Predicting Outcomes of Out-of-Hospital Cardiac Arrest Patients Treated with Therapeutic Hypothermia김성준, 김진주, 박원빈, 양혁준, 임용수, 조진성대한중환자의학회 · Acute and Critical Care2014 · 제29권 제4호Prognostic Value and Optimal Sampling Time of S-100B Protein for Outcome Prediction in Cardiac Arrest Patients Treated with Therapeutic Hypothermia김형석, 양혁준, 우재혁, 임용수, 장재호, 장지용, 정호성대한중환자의학회 · Acute and Critical Care2014 · 제29권 제4호Association between C-reactive protein-to-albumin ratio and 6-month mortality in out-of-hospital cardiac arrest김환희, 이동훈, 이병국, 이지호대한중환자의학회 · Acute and Critical Care2022 · 제37권 제4호저체온요법을 시행 받은 병원 외 심정지 환자들의 저체온요법 동안 혈당의 변화와 혈당과 예후의 관계김기태, 류현호, 문정미, 이거성, 이병국, 이형연, 전병조, 정경운, 정용훈대한중환자의학회 · Acute and Critical Care2012 · 제27권 제4호APACHE II Score Immediately after Cardiac Arrest as a Predictor of Good Neurological Outcome in Out-of-Hospital Cardiac Arrest Patients Receiving Targeted Temperature Management김상일, 김원영, 서동우, 손창환, 이윤선, 이재호, 임경수, Seung Mok Ryoo, You-Jin Lee, Youn-Jung Kim대한중환자의학회 · Acute and Critical Care2018 · 제33권 제2호

이 간행물의 다른 논문 (17건)

Do We Successfully Achieve Therapeutic Hypothermia?김우정pp. 243-245How to Enhance Critical Care in Korea: Challenges and Vision고윤석pp. 246-249Implementing a Sepsis Resuscitation Bundle Improved Clinical Outcome: A Before-and-After Study김정민, 고신옥, 유영철, 나성원pp. 250-256Extended-Spectrum β-Lactamase and Multidrug Resistance in Urinary Sepsis Patients Admitted to the Intensive Care Unit김성균, 김주희, 김태석, 박성훈, 정기석, 장승훈, 황용일, 이승순, 김범준pp. 257-265Clinical Characteristics of Respiratory Extracorporeal Life Support in Elderly Patients with Severe Acute Respiratory Distress Syndrome손봉수, 김도형, 윤성훈, 이승은, 김윤성, 김동완, 여혜주, 전두수, 조우현pp. 266-272
원문 보기