Thrombin-antithrombin levels are associated with survival in patients resuscitated from cardiac arrest

RESUSCITATION

卷:84

Article

Wertz, Jonathon¹  Doshi, Ankur A.²  Guyette, Francis X.²  Callaway, Clifton W.²  Rittenberger, Jon C.² 

[1] Univ Pittsburgh, Dept Med, Pittsburgh, PA 15261 USA

[2] Univ Pittsburgh, Dept Emergency Med, Pittsburgh, PA 15261 USA

关键词: Cardiac arrest;    Hypothermia;    Resuscitation;    Outcome;    Prognostication;    Temperature;   

DOI  :  10.1016/j.resuscitation.2013.03.022

来源: Elsevier

【 摘 要 】

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) inpatients 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 24 h 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 24 h 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. (C) 2013 Elsevier Ireland Ltd. All rights reserved.

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