• Jonathon Wertz, Ankur A Doshi, Francis X Guyette, Clifton W Callaway, and Jon C Rittenberger.
• University of Pittsburgh Department of Medicine, United States.
• Resuscitation. 2013 Oct 1;84(10):1400-3.

BackgroundFollowing successful resuscitation from cardiac arrest, a prothrombotic state may contribute to end-organ dysfunction. We examined whether the level of serum thrombin-antithrombin (TAT) in patients hospitalized after cardiac arrest was associated with survival or the development of multiple organ failure (MOF).MethodologyA prospective cohort study of subjects with in-hospital cardiac arrest (IHCA) or out-of-hospital cardiac arrest (OHCA) treated between 1/1/2007 and 5/30/2010 at a single tertiary care referral center. TAT levels were measured at hospital arrival and 24h after cardiac arrest. Logistic regression was used to determine associations between TAT levels and survival and development of MOF.ResultsData were available for 86 subjects. TAT levels decreased over time. Initial TAT levels (OR 0.03; 95%CI 0.001, 0.62) and category of illness severity (OR 0.39; 95% CI 0.21, 0.73) were associated with survival. Male gender (OR 3.86; 95% CI 1.17, 12.75) and category of illness severity (OR 1.86; 95% CI 1.09, 3.20), but not TAT levels were associated with development of MOF. Neither the 24-h TAT level, nor the change in TAT from initial to 24h was associated with survival when adjusted for category of illness severity.ConclusionsInitial serum TAT levels and category of illness severity are associated with survival. TAT levels are not associated with development of MOF. Initial TAT levels may be a useful prognostic adjunct in the post arrest population.Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

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