Cargando…

Immature/total granulocyte ratio improves early prediction of neurological outcome after out-of-hospital cardiac arrest: the MyeloScore study

BACKGROUND: Elevation of the immature/total granulocyte (I/T-G) ratio has been reported after out-of-hospital cardiac arrest (OHCA). Our purpose here was to evaluate the prognostic significance of the I/T-G ratio and to investigate whether the I/T-G ratio improves neurological outcome prediction aft...

Descripción completa

Detalles Bibliográficos
Autores principales: Sauneuf, Bertrand, Bouffard, Claire, Cornet, Edouard, Daubin, Cedric, Brunet, Jennifer, Seguin, Amélie, Valette, Xavier, Chapuis, Nicolas, du Cheyron, Damien, Parienti, Jean-Jacques, Terzi, Nicolas
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Springer Paris 2016
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4947062/
https://www.ncbi.nlm.nih.gov/pubmed/27422256
http://dx.doi.org/10.1186/s13613-016-0170-4
_version_ 1782443099859976192
author Sauneuf, Bertrand
Bouffard, Claire
Cornet, Edouard
Daubin, Cedric
Brunet, Jennifer
Seguin, Amélie
Valette, Xavier
Chapuis, Nicolas
du Cheyron, Damien
Parienti, Jean-Jacques
Terzi, Nicolas
author_facet Sauneuf, Bertrand
Bouffard, Claire
Cornet, Edouard
Daubin, Cedric
Brunet, Jennifer
Seguin, Amélie
Valette, Xavier
Chapuis, Nicolas
du Cheyron, Damien
Parienti, Jean-Jacques
Terzi, Nicolas
author_sort Sauneuf, Bertrand
collection PubMed
description BACKGROUND: Elevation of the immature/total granulocyte (I/T-G) ratio has been reported after out-of-hospital cardiac arrest (OHCA). Our purpose here was to evaluate the prognostic significance of the I/T-G ratio and to investigate whether the I/T-G ratio improves neurological outcome prediction after OHCA. METHODS: This single-center prospective cohort study included consecutive immunocompetent patients admitted to our intensive care unit over a 3-year period (2012–2014) after successfully resuscitated OHCA. The I/T-G ratio was determined in blood samples collected at admission. RESULTS: We studied 204 patients (77 % male, median age, 58 [48–67] years), of whom 64 % had a suspected cardiac cause of OHCA, 62 % died in the unit, and 31.5 % survived with good cerebral function. Independent outcome predictors by multivariate analysis were age, first shockable rhythm, bystander-initiated resuscitation, and I/T-G ratio. Compared to the model computed without the I/T-G ratio, the model with the ratio performed significantly better [areas under the ROC curves (AUCs), 0.78 vs. 0.83, respectively; P = 0.04]. These items were used to develop the MyeloScore equation: ([0.47 × I/T-G ratio] + [0.023 × age in years]) − 1.26 if initial VF/VT − 1.1 if bystander-initiated CPR. The MyeloScore predicted neurological outcomes with similar accuracy to the previously reported OHCA score (0.83 and 0.85, respectively; P = 0.6). The ROC–AUC was 0.84, providing external validation of the MyeloScore. CONCLUSIONS: The I/T-G ratio independently predicts neurological outcome after OHCA and, when added to other known risk factors, improves neurological outcome prediction. The clinical performance of the MyeloScore requires evaluation in a prospective study.
format Online
Article
Text
id pubmed-4947062
institution National Center for Biotechnology Information
language English
publishDate 2016
publisher Springer Paris
record_format MEDLINE/PubMed
spelling pubmed-49470622016-07-27 Immature/total granulocyte ratio improves early prediction of neurological outcome after out-of-hospital cardiac arrest: the MyeloScore study Sauneuf, Bertrand Bouffard, Claire Cornet, Edouard Daubin, Cedric Brunet, Jennifer Seguin, Amélie Valette, Xavier Chapuis, Nicolas du Cheyron, Damien Parienti, Jean-Jacques Terzi, Nicolas Ann Intensive Care Research BACKGROUND: Elevation of the immature/total granulocyte (I/T-G) ratio has been reported after out-of-hospital cardiac arrest (OHCA). Our purpose here was to evaluate the prognostic significance of the I/T-G ratio and to investigate whether the I/T-G ratio improves neurological outcome prediction after OHCA. METHODS: This single-center prospective cohort study included consecutive immunocompetent patients admitted to our intensive care unit over a 3-year period (2012–2014) after successfully resuscitated OHCA. The I/T-G ratio was determined in blood samples collected at admission. RESULTS: We studied 204 patients (77 % male, median age, 58 [48–67] years), of whom 64 % had a suspected cardiac cause of OHCA, 62 % died in the unit, and 31.5 % survived with good cerebral function. Independent outcome predictors by multivariate analysis were age, first shockable rhythm, bystander-initiated resuscitation, and I/T-G ratio. Compared to the model computed without the I/T-G ratio, the model with the ratio performed significantly better [areas under the ROC curves (AUCs), 0.78 vs. 0.83, respectively; P = 0.04]. These items were used to develop the MyeloScore equation: ([0.47 × I/T-G ratio] + [0.023 × age in years]) − 1.26 if initial VF/VT − 1.1 if bystander-initiated CPR. The MyeloScore predicted neurological outcomes with similar accuracy to the previously reported OHCA score (0.83 and 0.85, respectively; P = 0.6). The ROC–AUC was 0.84, providing external validation of the MyeloScore. CONCLUSIONS: The I/T-G ratio independently predicts neurological outcome after OHCA and, when added to other known risk factors, improves neurological outcome prediction. The clinical performance of the MyeloScore requires evaluation in a prospective study. Springer Paris 2016-07-16 /pmc/articles/PMC4947062/ /pubmed/27422256 http://dx.doi.org/10.1186/s13613-016-0170-4 Text en © The Author(s) 2016 Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made.
spellingShingle Research
Sauneuf, Bertrand
Bouffard, Claire
Cornet, Edouard
Daubin, Cedric
Brunet, Jennifer
Seguin, Amélie
Valette, Xavier
Chapuis, Nicolas
du Cheyron, Damien
Parienti, Jean-Jacques
Terzi, Nicolas
Immature/total granulocyte ratio improves early prediction of neurological outcome after out-of-hospital cardiac arrest: the MyeloScore study
title Immature/total granulocyte ratio improves early prediction of neurological outcome after out-of-hospital cardiac arrest: the MyeloScore study
title_full Immature/total granulocyte ratio improves early prediction of neurological outcome after out-of-hospital cardiac arrest: the MyeloScore study
title_fullStr Immature/total granulocyte ratio improves early prediction of neurological outcome after out-of-hospital cardiac arrest: the MyeloScore study
title_full_unstemmed Immature/total granulocyte ratio improves early prediction of neurological outcome after out-of-hospital cardiac arrest: the MyeloScore study
title_short Immature/total granulocyte ratio improves early prediction of neurological outcome after out-of-hospital cardiac arrest: the MyeloScore study
title_sort immature/total granulocyte ratio improves early prediction of neurological outcome after out-of-hospital cardiac arrest: the myeloscore study
topic Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4947062/
https://www.ncbi.nlm.nih.gov/pubmed/27422256
http://dx.doi.org/10.1186/s13613-016-0170-4
work_keys_str_mv AT sauneufbertrand immaturetotalgranulocyteratioimprovesearlypredictionofneurologicaloutcomeafteroutofhospitalcardiacarrestthemyeloscorestudy
AT bouffardclaire immaturetotalgranulocyteratioimprovesearlypredictionofneurologicaloutcomeafteroutofhospitalcardiacarrestthemyeloscorestudy
AT cornetedouard immaturetotalgranulocyteratioimprovesearlypredictionofneurologicaloutcomeafteroutofhospitalcardiacarrestthemyeloscorestudy
AT daubincedric immaturetotalgranulocyteratioimprovesearlypredictionofneurologicaloutcomeafteroutofhospitalcardiacarrestthemyeloscorestudy
AT brunetjennifer immaturetotalgranulocyteratioimprovesearlypredictionofneurologicaloutcomeafteroutofhospitalcardiacarrestthemyeloscorestudy
AT seguinamelie immaturetotalgranulocyteratioimprovesearlypredictionofneurologicaloutcomeafteroutofhospitalcardiacarrestthemyeloscorestudy
AT valettexavier immaturetotalgranulocyteratioimprovesearlypredictionofneurologicaloutcomeafteroutofhospitalcardiacarrestthemyeloscorestudy
AT chapuisnicolas immaturetotalgranulocyteratioimprovesearlypredictionofneurologicaloutcomeafteroutofhospitalcardiacarrestthemyeloscorestudy
AT ducheyrondamien immaturetotalgranulocyteratioimprovesearlypredictionofneurologicaloutcomeafteroutofhospitalcardiacarrestthemyeloscorestudy
AT parientijeanjacques immaturetotalgranulocyteratioimprovesearlypredictionofneurologicaloutcomeafteroutofhospitalcardiacarrestthemyeloscorestudy
AT terzinicolas immaturetotalgranulocyteratioimprovesearlypredictionofneurologicaloutcomeafteroutofhospitalcardiacarrestthemyeloscorestudy