Key result
In adult out-of-hospital cardiac arrest patients, leukocytosis was associated with a higher likelihood of sustained ROSC (OR 3.655), whereas hyperkalemia was associated with a reduced likelihood (OR 0.169).
Cohort (n=122)
No
In adult out-of-hospital cardiac arrest patients, leukocytosis and the absence of hyperkalemia upon emergency department arrival are strong independent predictors of achieving sustained return of spontaneous circulation.
Background. We examined factors associated with the successful resuscitation, in the emergency department (ED), of adult, out-of-hospital cardiac arrest (OHCA) patients.Methods. The study cohort consisted of adult patients (over 18 years of age) who presented to the ED in 2009 with a dia-gnosis of cardiac arrest. Data were retrieved from the institutional database. Results. A total of 122 adult, non-traumatic, OHCA patients were enrolled in the study. There were no significant differences between the sustained return of spontaneous circulation (ROSC) and non-sustained ROSC groups in initial body tempe-rature (P = 0.420), time to successful intubation (P = 0.524), time to first intravenous epinephrine injection (P = 0.108), blood sugar levels (P = 0.122), hematocrit (P = 0.977), cardiac enzymes (P = 0.116) and serum sodium level (P = 0.429). Leukocytosis (P = 0.047) and cardiac rhythm of pulseless ventricular tachycardia/ ventricular fibrillation and pulseless electrical activity (P = 0.022), were significantly associated with sustained ROSC. In contrast, patients with more severe acidosis (P = 0.003) and hyperkalemia (P < 0.001) had a reduced likelihood of achieving sustained ROSC. After multiple variable logistic regression analysis adjusting for variables, the correlation between sustained ROSC and leukocytosis and hyperkalemia remained high (leukocytosis, P = 0.007, odds ratio [OR] 3.655, 95% CI 1.422-9.395; hyperkalemia, P = 0.001, OR 0.169, 95% CI 0.057-0.500)Conclusion. Patients suffering an OHCA were appropriately resuscitated after arriving at the ED. Successful resuscitation in adult OHCA victims was determined by the patient’s status, in particular their white blood cell count and potassium level.
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Chen et al. (2011) conducted a cohort in Out-of-hospital cardiac arrest (n=122). Leukocytosis (WBC > 11000/uL) vs. WBC ≤ 11000/uL was evaluated on Sustained return of spontaneous circulation (ROSC) (OR 3.655, 95% CI 1.422-9.395, p=0.007). In adult out-of-hospital cardiac arrest patients, leukocytosis was associated with a higher likelihood of sustained ROSC (OR 3.655), whereas hyperkalemia was associated with a reduced likelihood (OR 0.169).
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