TY - JOUR
T1 - Prognostic impact of serum albumin concentration for neurologically favorable outcome in patients treated with targeted temperature management after out-of-hospital cardiac arrest
T2 - A multicenter prospective study
AU - Matsuyama, Tasuku
AU - Iwami, Taku
AU - Yamada, Tomoki
AU - Hayakawa, Koichi
AU - Yoshiya, Kazuhisa
AU - Irisawa, Taro
AU - Abe, Yoshio
AU - Nishimura, Tetsuro
AU - Uejima, Toshifumi
AU - Ohishi, Yasuo
AU - Kiguchi, Takeyuki
AU - Kishi, Masashi
AU - Kishimoto, Masafumi
AU - Nakao, Shota
AU - Hayashi, Yasuyuki
AU - Sogabe, Taku
AU - Morooka, Takaya
AU - Izawa, Junichi
AU - Shimamoto, Tomonari
AU - Hatakeyama, Toshihiro
AU - Fujii, Tomoko
AU - Sado, Junya
AU - Kawamura, Takashi
AU - Shimazu, Takeshi
AU - Kitamura, Tetsuhisa
PY - 2018/9/1
Y1 - 2018/9/1
N2 - To assess whether serum albumin concentration measured upon hospital arrival was useful as an early prognostic biomarker for neurologically favorable outcome in out-of-hospital cardiac arrest (OHCA) patients treated with target temperature management (TTM). This prospective, multicenter observational study (The CRITICAL Study) carried out between July 1, 2012 and December 31, 2014 in Osaka Prefecture, Japan involving 13 critical care medical centers (CCMCs) and one non-CCMC with an emergency department. This study included patients ≥18 years of age who underwent an OHCA, for whom resuscitation was attempted by Emergency Medical Services personnel and were then transported to participating institutions, and who were then treated with TTM. Based on the serum albumin concentration upon hospital arrival, involved patients were divided into four quartiles (Q1-Q4) defined as Q1 (<3.0 g/dL), Q2 (≥3.0, <3.4 g/dL), Q3 (≥3.4, <3.8 g/dL), and Q4 (≥3.8 g/dL). The primary outcome of this study was 1-month survival with neurologically favorable outcome defined by cerebral performance category 1 or 2. During the study period, a total of 327 were eligible for our analysis. The overall proportion of neurologically favorable outcome was 33.0% (108/327). The Q4 group had the highest proportion of neurologically favorable outcome (52.5% [48/91]), followed by Q3 (34.5% [30/87]), Q2 (27.3% [21/77]), and Q1 (12.5% [9/72]). The multivariable logistic regression analysis demonstrated that the proportion of neurologically favorable outcome was significantly higher in the Q4 group than that in the Q1 group (adjusted odds ratio 10.39; 95% confidence interval 3.36-32.17). The adjusted proportion of neurologically favorable outcome increased in a stepwise fashion across increasing quartiles (p < 0.001). In this study, higher serum albumin concentration upon hospital arrival had a positive association with neurologically favorable outcome after OHCA in a dose-dependent manner.
AB - To assess whether serum albumin concentration measured upon hospital arrival was useful as an early prognostic biomarker for neurologically favorable outcome in out-of-hospital cardiac arrest (OHCA) patients treated with target temperature management (TTM). This prospective, multicenter observational study (The CRITICAL Study) carried out between July 1, 2012 and December 31, 2014 in Osaka Prefecture, Japan involving 13 critical care medical centers (CCMCs) and one non-CCMC with an emergency department. This study included patients ≥18 years of age who underwent an OHCA, for whom resuscitation was attempted by Emergency Medical Services personnel and were then transported to participating institutions, and who were then treated with TTM. Based on the serum albumin concentration upon hospital arrival, involved patients were divided into four quartiles (Q1-Q4) defined as Q1 (<3.0 g/dL), Q2 (≥3.0, <3.4 g/dL), Q3 (≥3.4, <3.8 g/dL), and Q4 (≥3.8 g/dL). The primary outcome of this study was 1-month survival with neurologically favorable outcome defined by cerebral performance category 1 or 2. During the study period, a total of 327 were eligible for our analysis. The overall proportion of neurologically favorable outcome was 33.0% (108/327). The Q4 group had the highest proportion of neurologically favorable outcome (52.5% [48/91]), followed by Q3 (34.5% [30/87]), Q2 (27.3% [21/77]), and Q1 (12.5% [9/72]). The multivariable logistic regression analysis demonstrated that the proportion of neurologically favorable outcome was significantly higher in the Q4 group than that in the Q1 group (adjusted odds ratio 10.39; 95% confidence interval 3.36-32.17). The adjusted proportion of neurologically favorable outcome increased in a stepwise fashion across increasing quartiles (p < 0.001). In this study, higher serum albumin concentration upon hospital arrival had a positive association with neurologically favorable outcome after OHCA in a dose-dependent manner.
KW - brain edema
KW - early prediction
KW - out-of-hospital cardiac arrest
KW - postcardiac arrest syndrome
KW - serum albumin concentration
KW - targeted temperature management
UR - http://www.scopus.com/inward/record.url?scp=85052919255&partnerID=8YFLogxK
U2 - 10.1089/ther.2017.0053
DO - 10.1089/ther.2017.0053
M3 - Article
C2 - 29364051
AN - SCOPUS:85052919255
VL - 8
SP - 165
EP - 172
JO - Therapeutic Hypothermia and Temperature Management
JF - Therapeutic Hypothermia and Temperature Management
SN - 2153-7658
IS - 3
ER -