title: Fibrin/fibrinogen degradation products (FDP) at hospital admission predict neurological outcomes in out-of-hospital cardiac arrest patients.
abstract: 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.
  
  
  
  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.
  
  
  
  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.
  
  
  
  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.
authors.affiliation: Hokkaido University, Division of Acute and Critical Care Medicine, Department of Anesthesiology and Critical Care Medicine, Hokkaido University Graduate School of Medicine, Sapporo, Hokkaido, Japan. Electronic address: rjtkk3299@yahoo.co.jp.
authors.forename: Yuichi
authors.initials: Y
authors.lastname: Ono
authors.affiliation: Hokkaido University, Division of Acute and Critical Care Medicine, Department of Anesthesiology and Critical Care Medicine, Hokkaido University Graduate School of Medicine, Sapporo, Hokkaido, Japan.
authors.forename: Mineji
authors.initials: M
authors.lastname: Hayakawa
authors.affiliation: Hokkaido University, Division of Acute and Critical Care Medicine, Department of Anesthesiology and Critical Care Medicine, Hokkaido University Graduate School of Medicine, Sapporo, Hokkaido, Japan.
authors.forename: Kunihiko
authors.initials: K
authors.lastname: Maekawa
authors.affiliation: Hokkaido University, Division of Acute and Critical Care Medicine, Department of Anesthesiology and Critical Care Medicine, Hokkaido University Graduate School of Medicine, Sapporo, Hokkaido, Japan.
authors.forename: Akira
authors.initials: A
authors.lastname: Kodate
authors.affiliation: Hokkaido University, Division of Acute and Critical Care Medicine, Department of Anesthesiology and Critical Care Medicine, Hokkaido University Graduate School of Medicine, Sapporo, Hokkaido, Japan.
authors.forename: Yoshihiro
authors.initials: Y
authors.lastname: Sadamoto
authors.affiliation: Hokkaido University, Division of Acute and Critical Care Medicine, Department of Anesthesiology and Critical Care Medicine, Hokkaido University Graduate School of Medicine, Sapporo, Hokkaido, Japan.
authors.forename: Naoki
authors.initials: N
authors.lastname: Tominaga
authors.affiliation: Hokkaido University, Division of Acute and Critical Care Medicine, Department of Anesthesiology and Critical Care Medicine, Hokkaido University Graduate School of Medicine, Sapporo, Hokkaido, Japan.
authors.forename: Hiromoto
authors.initials: H
authors.lastname: Murakami
authors.affiliation: Hokkaido University, Division of Acute and Critical Care Medicine, Department of Anesthesiology and Critical Care Medicine, Hokkaido University Graduate School of Medicine, Sapporo, Hokkaido, Japan.
authors.forename: Tomonao
authors.initials: T
authors.lastname: Yoshida
authors.affiliation: Hokkaido University, Division of Acute and Critical Care Medicine, Department of Anesthesiology and Critical Care Medicine, Hokkaido University Graduate School of Medicine, Sapporo, Hokkaido, Japan.
authors.forename: Kenichi
authors.initials: K
authors.lastname: Katabami
authors.affiliation: Hokkaido University, Division of Acute and Critical Care Medicine, Department of Anesthesiology and Critical Care Medicine, Hokkaido University Graduate School of Medicine, Sapporo, Hokkaido, Japan.
authors.forename: Takeshi
authors.initials: T
authors.lastname: Wada
authors.affiliation: Hokkaido University, Division of Acute and Critical Care Medicine, Department of Anesthesiology and Critical Care Medicine, Hokkaido University Graduate School of Medicine, Sapporo, Hokkaido, Japan.
authors.forename: Hisako
authors.initials: H
authors.lastname: Sageshima
authors.affiliation: Hokkaido University, Division of Acute and Critical Care Medicine, Department of Anesthesiology and Critical Care Medicine, Hokkaido University Graduate School of Medicine, Sapporo, Hokkaido, Japan.
authors.forename: Atsushi
authors.initials: A
authors.lastname: Sawamura
authors.affiliation: Hokkaido University, Division of Acute and Critical Care Medicine, Department of Anesthesiology and Critical Care Medicine, Hokkaido University Graduate School of Medicine, Sapporo, Hokkaido, Japan.
authors.forename: Satoshi
authors.initials: S
authors.lastname: Gando
mesh_terms: D000368:Aged; D004211:Disseminated Intravascular Coagulation / Q000209:etiology / Q000628:therapy; D005260:Female; D005338:Fibrin Fibrinogen Degradation Products / Q000627:therapeutic use*; D005544:Forecasting; D006801:Humans; D008297:Male; D008875:Middle Aged; D058687:Out-of-Hospital Cardiac Arrest / Q000150:complications / Q000628:therapy*; D010343:Patient Admission; D011379:Prognosis; D012372:ROC Curve; D012189:Retrospective Studies
chemical_list: D005338:Fibrin Fibrinogen Degradation Products
keywords: Cardiopulmonary resuscitation; Neurological outcome; Out-of-hospital cardiac arrest