Abstract 19470: Presence of Anemia at Induction of Therapeutic Hypothermia as a Predictor of Neurological Outcome in Cardiac Arrest Survivors

Abstract

Introduction: Therapeutic hypothermia (TH) has become an accepted practice to improve neurological outcome in survivors of cardiac arrest. Co-morbid factors that may impact neurological outcome in such patients are not well understood. Anemia has been shown to have a prognostic value in a wide variety of diseases. We investigated the effect of hematocrit on neurological outcome in cardiac arrest survivors undergoing TH. Methods: A retrospective analysis was performed on 196 consecutive cardiac arrest survivors who underwent TH with endovascular cooling in the cardiac intensive care unit at a tertiary care center between January 2007 and April 2012. Patients were divided into two groups based on anemia as per their hematocrit (Hct) value at induction of TH (Hct≤36 and Hct>36). The primary endpoint was measured using the Pittsburgh cerebral performance category (CPC) scale and patients were assessed for a good (CPC 1 and 2) or poor (CPC 3-5) neurological outcome prior to discharge from hospital. Results: Of the 196 patients, 130 patients (66 %) had a Hct ≤ 36 and 66 patients (34 %) had a Hct > 36. Forty two (32%) patients with Hct ≤ 36 and 25 patients (38%) with Hct>36 had a good neurologic outcome (P=0.50) (Figure 1) . On multivariable analysis, initial/presenting rhythm (OR: 8.752; 95 % CI 2.60-29.40, P< 0.001) and time to return of spontaneous circulation (OR: 0.942; 95 % CI 0.90-0.99, P=0.02) were independent predictors of neurologic outcome. Conclusion: Presence of anemia at induction of TH is not associated with neurological outcome in cardiac arrest survivors.