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Fibrin/fibrinogen degradation products (FDP) at hospital admission predict neurological outcomes in out-of-hospital cardiac arrest patients

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Title: Fibrin/fibrinogen degradation products (FDP) at hospital admission predict neurological outcomes in out-of-hospital cardiac arrest patients
Authors: Ono, Yuichi Browse this author
Hayakawa, Mineji Browse this author →KAKEN DB
Maekawa, Kunihiko Browse this author
Kodate, Akira Browse this author
Sadamoto, Yoshihiro Browse this author
Tominaga, Naoki Browse this author
Murakami, Hiromoto Browse this author
Yoshida, Tomonao Browse this author
Katabami, Kenichi Browse this author
Wada, Takeshi Browse this author →KAKEN DB
Sageshima, Hisako Browse this author
Sawamura, Atsushi Browse this author →KAKEN DB
Gando, Satoshi Browse this author →KAKEN DB
Keywords: Cardiopulmonary resuscitation
Out-of-hospital cardiac arrest
Neurological outcome
Issue Date: Feb-2017
Publisher: Elsevier
Journal Title: Resuscitation
Volume: 111
Start Page: 62
End Page: 67
Publisher DOI: 10.1016/j.resuscitation.2016.11.017
PMID: 27940211
Abstract: Objective: This study aimed to test the hypothesis that coagulation, fibrinolytic markers and disseminated intravascular coagulation (DIC) score (International Society on Thrombosis and Haemostasis) at hospital admission of out-of-hospital cardiac arrest (OHCA) patients can predict neurological outcomes 1 month after cardiac arrest. Methods: In this retrospective, observational analysis, data were collected from the Sapporo Utstein Registry and medical records at Hokkaido University Hospital. We included patients who experienced OHCA with successful return of spontaneous circulation (ROSC) between 2006 and 2012 and were transferred to Hokkaido University Hospital. From medical records, we collected information about the following coagulation and fibrinolytic factors at hospital admission: platelet count; prothrombin time; activated partial thromboplastin time; plasma levels of fibrinogen, D-dimer, fibrin/fibrinogen degradation products (FDP), and antithrombin; and calculated DIC score. Favorable neurological outcomes were defined as a cerebral performance category 1-2. Results: We analyzed data for 315 patients. Except for fibrinogen level, all coagulation variables, fibrinolytic variables, and DIC score were associated with favorable neurological outcomes. In the receiver operating characteristic curve analysis, FDP level had the largest area under the curve (AUC; 0.795). In addition, the AUC of FDP level was larger than that of lactate level. The AUC value of FDP level might indicate that FDP is an independent predictor of favorable neurological outcomes. Conclusions: All of the coagulation and fibrinolytic markers, except for fibrinogen level, and DIC score at hospital admission, were associated with favorable neurological outcomes. Of all of the variables, FDP level was most closely associated with favorable neurological outcomes in OHCA patients who successfully achieved ROSC.
Rights: © 2017. This manuscript version is made available under the CC-BY-NC-ND 4.0 license
Type: article (author version)
Appears in Collections:医学院・医学研究院 (Graduate School of Medicine / Faculty of Medicine) > 雑誌発表論文等 (Peer-reviewed Journal Articles, etc)

Submitter: 早川 峰司

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