Department of Anesthesiology and Reanimation, University of Health Sciences, Mehmet Akif Inan Training and Research Hospital, Sanliurfa, Turkey.
Department of Cardiology, University of Health Sciences, Mehmet Akif Inan Training and Research Hospital, Sanliurfa, Turkey.
Int J Clin Pract. 2021 Jul;75(7):e14227. doi: 10.1111/ijcp.14227. Epub 2021 Apr 27.
Despite major advances in basic and advanced life supports, patients who survived from out-of-hospital cardiac arrest (OHCA) have still poor prognosis. Several inflammatory parameters have been used to determine early and long-term prognosis in patients with OHCA. C-reactive protein-to-albumin ratio (CAR) is also a novel marker of systemic inflammation. To our knowledge, there is no study evaluating the clinical importance of CAR in OHCA patients.
To evaluate the effect of CAR on in-hospital mortality in patients with OHCA.
A total of 102 patients with OHCA were included in this study. The study population was divided into two groups as survivour (n = 43) and non-survivour (n = 59) during follow-up. Complete blood cell counts, biochemical and blood gas analyses were recorded for all patients. Neutrophil to lymphocyte ratio (NLR) was calculated as the ratio of neutrophil to lymphocyte. CAR was calculated as the ratio of C-reactive protein to the albumin.
NLR (P = .012), CAR (P < .001) and serum lactate level (P = .002) were significantly higher whereas lymphocyte (P = .008) and serum albumin (P < .001) were significantly lower in the non-survivour group compared with the survivour group. Multivariate logistic regression analysis showed that NLR (odds ratio [OR]: 1.044, 95% confidence interval [CI]: 1.044-1.437, P = .013), CAR (OR: 1.971, 95% CI: 1.327-2.930, P = .001) and lactate level (OR: 1.268, 95% CI: 1.095-1.469, P = .002) were independent predictors of in-hospital mortality.
We have demonstrated for the first time that CAR was an independent predictor of in-hospital mortality in OHCA patients.
尽管基础和高级生命支持取得了重大进展，但从院外心脏骤停（OHCA）中幸存的患者预后仍然较差。几项炎症参数已被用于确定 OHCA 患者的早期和长期预后。C 反应蛋白与白蛋白比值（CAR）也是全身炎症的一种新标志物。据我们所知，尚无研究评估 CAR 在 OHCA 患者中的临床重要性。
评估 CAR 对 OHCA 患者院内死亡率的影响。
本研究共纳入 102 例 OHCA 患者。在随访期间，将研究人群分为存活组（n=43）和非存活组（n=59）。记录所有患者的全血细胞计数、生化和血气分析。中性粒细胞与淋巴细胞比值（NLR）计算为中性粒细胞与淋巴细胞的比值。CAR 计算为 C 反应蛋白与白蛋白的比值。
NLR（P=0.012）、CAR（P<0.001）和血清乳酸水平（P=0.002）在非存活组显著高于存活组，而淋巴细胞（P=0.008）和血清白蛋白（P<0.001）在非存活组显著低于存活组。多变量逻辑回归分析显示，NLR（比值比[OR]：1.044，95%置信区间[CI]：1.044-1.437，P=0.013）、CAR（OR：1.971，95% CI：1.327-2.930，P=0.001）和乳酸水平（OR：1.268，95% CI：1.095-1.469，P=0.002）是院内死亡率的独立预测因素。
我们首次证明 CAR 是 OHCA 患者院内死亡率的独立预测因素。
