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

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 Augus...

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Bibliographic Details
Main Authors: Seongtak Kim, Jinseong Cho, Yongsu Lim, Jinjoo Kim, Hyukjun Yang, Gun Lee
Format: Article
Language:English
Published: Korean Society of Critical Care Medicine 2014-11-01
Series:Korean Journal of Critical Care Medicine
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Online Access:http://www.kjccm.org/upload/pdf/kjccm-2014-29-4-313.pdf
Description
Summary: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.
ISSN:2383-4870