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Aims to explore the association between post return of spontaneous circulation (ROSC) hemoglobin level and survival with good neurological outcome following out-of-hospital cardiac arrest. Methods We studied adults with non-traumatic out-of-hospital cardiac arrest who achieved ROSC within 50 minutes of collapse. We quantified the association between post ROSC hemoglobin level and good neurological outcome (defined as Cerebral Performance Category score of 1or 2), using multivariate logistic regression analyses. The impact of Post ROSC hemoglobin level ≥ 10 g/dl and time varying hemoglobin level ≥ 10 g/dl on time to Survival with good outcome was assessed using Cox proportional hazard models. Results Of 931 cardiac arrest patients, 146 (16%) achieved ROSC and 30 survived to discharge with a good neurological outcome. Of those with post ROSC hemoglobin level ≥ 10 g/dl, 28% (27/98) had good outcome, whereas of those with level < 10 mg/dl only 6% (3/48) had good outcome (CPC < 3, p=0.003). The use of blood transfusions and therapeutic hypothermia were comparable in both good and bad outcome groups. An immediate post ROSC hemoglobin level ≥ 10 g/dl was significantly associated with good neurological outcome (AOR 8.31 95% CI 1.89–36.52 p=0.005). Patients with post ROSC hemoglobin ≥ 10 g/dl were more likely to achieve good outcome earlier (HR 6.02 95% CI 1.75–20.72 p=0.004). Conclusions Post ROSC hemoglobin level ≥ 10 g/dl is associated with survival with good neurological outcome. The importance of time to achieve such level and the role of blood transfusion warrants further investigation.

Background:In-hospital left ventricular (LV) thrombus following acute ST-elevation myocardial infarction (STEMI) has not been evaluated on a national scale and was the focus of this investigation. Methods:We used the 2003 to 2013 Nationwide Inpatient Sample database to identify adults ≥ 18 years old with a principal diagnosis code of ST-elevation myocardial infarction. Patients were divided into two groups defined by the presence or absence of LV thrombus. Clinical characteristics and in-hospital outcomes were studied using relevant statistics. Multiple linear and logistic regression models were conducted to identify factors associated with LV thrombus.Results: Of 1,035,888 STEMI patients hospitalized in the U.S from 2003-2013, 1,982 (0.2%) developed acute in-hospital LV thrombus. Compared to no LV thrombus, patients with LV thrombus were more likely to have in-hospital complications; acute ischemic and hemorrhagic stroke, acute renal failure, gastrointestinal bleed, cardiogenic shock, in-hospital cardiac arrest and mortality. They also had longer mean length of stay and higher hospital charges. Factors associated with LV thrombus included: anterior/anterolateral STEMI, acute or chronic heart failure