Hemoglobin as a prognostic marker for neurological outcomes in post-cardiac arrest patients: a meta-analysis

Area of Science:

• Cardiology
• Neurology
• Critical Care Medicine

Background:

• Cardiac arrest (CA) is a critical event with significant neurological sequelae.
• Neurological outcomes post-CA are a primary determinant of patient survival and quality of life.
• The role of specific physiological parameters, like serum hemoglobin, in influencing these outcomes requires further elucidation.

Purpose of the Study:

• To investigate the association between serum hemoglobin levels and neurological prognosis in patients following cardiac arrest.
• To synthesize evidence from existing studies through a meta-analysis.

Main Methods:

• A systematic literature search was conducted across major databases (PubMed, Web of Science, Cochrane Library, Embase) from June 2012 to April 2023.
• Eleven studies comprising 2519 patients were included after rigorous review.
• Standardized Mean Difference (SMD) with 95% Confidence Intervals (CI) was used for pooled effect estimation; study quality and heterogeneity were assessed.

Main Results:

• The meta-analysis revealed a statistically significant association between higher serum hemoglobin levels and improved neurological prognosis (SMD = 0.60, 95% CI = 0.49-0.71).
• Low heterogeneity was observed (I² = 10.85%), suggesting consistency across the included studies.
• Subgroup analyses were performed to identify potential confounding factors.

Conclusions:

• Serum hemoglobin level is a potential biomarker for predicting neurological outcomes after cardiac arrest.
• Maintaining an appropriate or elevated serum hemoglobin level may be a therapeutic strategy to enhance neurological recovery in post-cardiac arrest patients.