Identifying a patient with a poor prognosis after a cardiac arrest is useful clinically for both planning and family notification. You et al identified factors affected neurological outcomes and mortality. The authors are from Yonsei University in Seoul.
The thrombotic microangiopathy score is a measure of schistocytosis and ranges from 0 to 5. Its use in cardiac arrest could be related to release of thromboplastin-like material from ischemic brain tissue.
Patient selection: cardiac arrest
Predictors of poor neurological outcome:
(1) TMA score >= 2 at 12 hours (OR 6.3)
(2) prolonged low-flow time (OR 1.1)
(3) elevated arterial lactate (OR 1.1)
Predictors of better neurological outcome:
(1) initial shockable rhythm (OR 0.33)
(2) cardiac origin to arrest (OR 0.24)
Predictors of poor 30-day mortality:
(1) TMA score >= 2 at 12 hours (OR 2.7)
(2) older age (OR 1.03)
(3) prolonged low-flow time (OR 1.02)
(4) elevated arterial lactate (OR 1.1)
Predictors of better 30-day mortality:
(1) witnessed collapse (OR 0.58)
