Kim Hui Hwan, Lee Ji Ho, Lee Dong Hun, Lee Byung Kook
Department of Emergency Medicine, Chonnam National University Hospital, Gwangju, Korea.
Department of Emergency Medicine, Chonnam National University Medical School, Gwangju, Korea.
Acute Crit Care. 2022 Nov;37(4):601-609. doi: 10.4266/acc.2022.00542. Epub 2022 Aug 18.
The inflammatory response that occurs following cardiac arrest can determine the long-term prognosis of patients who survive out-of-hospital cardiac arrest. We evaluated the correlation between C-reactive protein-to-albumin ratio (CAR) following cardiac arrest and long-term mortality.
The current retrospective observational study examined patients with post-cardiac arrest syndrome (PCAS) treated with targeted temperature management at a single tertiary care hospital. We measured CAR at four time points (at admission and then 24 hours, 48 hours, and 72 hours after) following cardiac arrest. The primary outcome was the patients' 6-month mortality. We performed multivariable and area under the receiver operating characteristic curve (AUC) analyses to investigate the relationship between CAR and 6-month mortality.
Among the 115 patients, 52 (44.1%) died within 6 months. In the multivariable analysis, CAR at 48 hours (odds ratio [OR], 1.130; 95% confidence interval [CI], 1.027-1.244) and 72 hours (OR, 1.241; 95% CI, 1.059-1.455) after cardiac arrest was independently associated with 6-month mortality. The AUCs of CAR at admission and 24, 48, and 72 hours after cardiac arrest for predicting 6-month mortality were 0.583 (95% CI, 0.489-0.673), 0.622 (95% CI, 0.528-0.710), 0.706 (95% CI, 0.615-0.786), and 0.762 (95% CI, 0.675-0.835), respectively.
CAR at 72 hours after cardiac arrest was an independent predictor for long-term mortality in patients with PCAS.
心脏骤停后发生的炎症反应可决定院外心脏骤停存活患者的长期预后。我们评估了心脏骤停后C反应蛋白与白蛋白比值（CAR）与长期死亡率之间的相关性。
本项回顾性观察研究对一家三级护理医院中接受目标温度管理治疗的心脏骤停后综合征（PCAS）患者进行了检查。我们在心脏骤停后的四个时间点（入院时以及之后的24小时、48小时和72小时）测量了CAR。主要结局是患者的6个月死亡率。我们进行了多变量分析和受试者工作特征曲线下面积（AUC）分析，以研究CAR与6个月死亡率之间的关系。
在115例患者中，52例（44.1%）在6个月内死亡。在多变量分析中，心脏骤停后48小时（优势比[OR]，1.130；95%置信区间[CI]，1.027 - 1.244）和72小时（OR，1.241；95%CI，1.059 - 1.455）的CAR与6个月死亡率独立相关。心脏骤停后入院时、24小时、48小时和72小时的CAR预测6个月死亡率的AUC分别为0.583（95%CI，0.489 - 0.673）、0.622（95%CI，0.528 - 0.710）、0.706（95%CI，0.615 - 0.786）和0.762（95%CI，0.675 - 0.835）。
心脏骤停后72小时的CAR是PCAS患者长期死亡率的独立预测指标。
