Association between the platelet-to-hemoglobin ratio and survival-to-discharge in comatose patients with out-of-hospital cardiac arrest with an initial shockable rhythm: a retrospective cohort study

Park, Yeon Ah; Park, Eun Jung; Min, Young Gi; Park, Min Ji; Lee, Sung Eun

J Korean Soc Emerg Med > Volume 35(3); 2024 > Article

Original Article

Journal of The Korean Society of Emergency Medicine 2024;35(3): 203-211.

Association between the platelet-to-hemoglobin ratio and survival-to-discharge in comatose patients with out-of-hospital cardiac arrest with an initial shockable rhythm: a retrospective cohort study

, Sung Eun Lee^1,2

¹Department of Emergency Medicine, Ajou University School of Medicine, Suwon, Korea
²Department of Neurology, Ajou University School of Medicine, Suwon, Korea

Correspondence

Sung Eun Lee ,Tel: 031-219-7757, Fax: 031-219-7760, Email: plumpboy@hanmail.net,

Received: September 2, 2023; Revised: October 1, 2023 Accepted: October 22, 2023. Published online: June 30, 2024.

ABSTRACT

Objective:
This study examined whether the platelet-to-hemoglobin ratio (PHR) is associated with survival-to-discharge in comatose patients with out-of-hospital cardiac arrest (OHCA) with an initial shockable rhythm.
Method:
This retrospective cohort study included adult comatose patients after OHCA with an initial shockable rhythm between January 2015 and December 2021. This study analyzed the relationship between the basic characteristics and initial laboratory findings, including PHR, and survival-to-discharge. The primary outcome was defined as survival-to-discharge, and the secondary outcome was a good neurological outcome (cerebral performance category 1-2) at the time of discharge.
Results:
One hundred and ten patients were included in this study, of whom 86 (78%) survived to discharge. The survival-to-discharge group had a significantly higher initial platelet count (238.5±78.1 vs. 158.4±47.2 ×103/μL; P<0.05) and PHR (1.7±0.5 vs. 1.2±0.3; P<0.05) than the non-survival-to-discharge group. Even after adjusting for multiple confounding factors, platelet count and PHR remained associated with survival-to-discharge (adjusted odds ratio [aOR] of 1.02, 95% confidence interval [CI] 1.01-1.03, P=0.009 and aOR of 9.99, 95% CI 1.96-50.87, P=0.006, respectively). The platelet count and PHR feasibly predicted the survival-to-discharge (area under the receiver operating characteristic curves are 0.831 and 0.806, respectively).
Conclusion:
In this cohort study, a high platelet count and PHR could be associated with the survival-to-discharge in patients with OHCA with an initial shockable rhythm.

Key words: Initial shockable rhythm; Out-of-hospital cardiac arrest; Blood platelets; Predictive value of tests; Prognosis; Survival