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Usefulness of mean platelet volume as a marker for clinical outcomes after out-of-hospital cardiac arrest: a retrospective cohort study

Authors
 S. P. Chung  ;  H. Y. Yune  ;  Y. S. Park  ;  J. S You  ;  J. H. Hong  ;  T. Kong  ;  J. W. Park  ;  H. S. Chung  ;  I. Park 
Citation
 Journal of Thrombosis and Haemostasis, Vol.14(10) : 2036-2044, 2016 
Journal Title
 Journal of Thrombosis and Haemostasis 
ISSN
 1538-7933 
Issue Date
2016
MeSH
Adult ; Aged ; Biomarkers/blood* ; Endothelium, Vascular/pathology ; Female ; Hospital Mortality ; Humans ; Inflammation ; Male ; Mean Platelet Volume* ; Middle Aged ; Out-of-Hospital Cardiac Arrest/blood* ; Out-of-Hospital Cardiac Arrest/mortality* ; Patient Admission ; Platelet Activation ; Proportional Hazards Models ; Reperfusion Injury ; Resuscitation ; Retrospective Studies ; Sepsis/pathology ; Time Factors ; Treatment Outcome
Keywords
biological marker ; heart arrest ; mean platelet volume ; mortality ; patient outcome assessment
Abstract
Essentials It is unknown whether mean platelet volume (MPV) estimates outcomes after cardiac arrest (CA). We investigated whether MPV was associated with 30-day neurologic outcome and mortality after CA. Elevated MPV at admission was associated with poor neurological outcomes and mortality at 30 days. Identifying levels of MPV is helpful for estimating disease severity among resuscitated patients. SUMMARY: Background Whole-body ischemia followed by reperfusion during cardiac arrest and after return of spontaneous circulation (ROSC) triggers systemic sterile inflammatory responses, inducing a sepsis-like state during post-cardiac arrest syndrome. Activated platelets are enlarged, and contain vasoactive and prothrombic factors that aggravate systemic inflammation and endothelial dysfunction. Objectives To investigate whether mean platelet volume (MPV) is useful as a marker for early mortality and neurologic outcomes in patients who achieve ROSC after out-of-hospital cardiac arrest (OHCA). Methods OHCA records from the Emergency Department Cardiac Arrest Registry were retrospectively analyzed. Patients who survived for > 24 h after ROSC were included. We evaluated mortality and cerebral performance category scores after 30 days. Results We analyzed records from 184 patients with OHCA. Increased 30-day mortality among patients who achieved ROSC after OHCA was associated with MPV at admission (hazard ratio [HR] 1.36; 95% confidence interval [CI] 1.06-1.75). An elevated MPV at admission was also associated with poor neurologic outcomes (HR 1.28; 95% CI 1.06-1.55). Conclusions An elevated MPV was independently associated with increased 30-day mortality, with the highest discriminative value being obtained upon admission after OHCA. An elevated MPV on admission was associated with poor neurologic outcomes. High MPVs are helpful for estimating 30-day mortality and neurologic outcomes among patients who achieve ROSC after OHCA.
Full Text
http://onlinelibrary.wiley.com/doi/10.1111/jth.13421/abstract
DOI
10.1111/jth.13421
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Emergency Medicine (응급의학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Yonsei Biomedical Research Center (연세의생명연구원) > 1. Journal Papers
Yonsei Authors
공태영(Kong, Tae Young) ORCID logo https://orcid.org/0000-0002-4182-7245
박유석(Park, Yoo Seok) ORCID logo https://orcid.org/0000-0003-1543-4664
박인철(Park, In Cheol) ORCID logo https://orcid.org/0000-0001-7033-766X
유제성(You, Je Sung) ORCID logo https://orcid.org/0000-0002-2074-6745
윤호영(Yune, Ho Young)
정성필(Chung, Sung Pil) ORCID logo https://orcid.org/0000-0002-3074-011X
정현수(Chung, Hyun Soo) ORCID logo https://orcid.org/0000-0001-6110-1495
홍정화(Hong, Jung Hwa)
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URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/152507
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