Yoon Ju Hee, Choi Woo Sung, Lim Yong Su, Jang Jae Ho
Department of Emergency Medicine, Gachon University Gil Medical Center, Incheon 21565, Republic of Korea.
Department of Emergency Medicine, Gachon University College of Medicine, Incheon 21565, Republic of Korea.
J Clin Med. 2023 Jul 9;12(14):4568. doi: 10.3390/jcm12144568.
(1) Background: Post-cardiac arrest syndrome (PCAS) is a type of global ischemic reperfusion injury that occurs after the return of spontaneous circulation (ROSC). The procalcitonin to albumin ratio (PAR) has been studied as an independent prognostic factor of various diseases. There are no previous studies of PAR in patients with PCAS. We assessed if PAR is more effective than procalcitonin (PCT) in predicting prognosis for patients with PCAS. (2) Methods: This retrospective cohort study included a total of 187 patients with PCAS after non-traumatic out-of-hospital cardiac arrest (OHCA) between January 2016 and December 2020. Multivariate logistic regression analysis was conducted to assess the association between PAR and PCAS prognosis. The predictive performance of PAR was compared with PCT via the receiver-operating characteristic (ROC) analysis and DeLong test.; (3) Results: PAR at 24 and 48 h after hospital admission were independently associated with one-month neurological outcome (OR: 1.167, 95% CI: 1.023-1.330; OR: 1.077, 95% CI: 1.012-1.146, < 0.05). By ROC analysis, PAR showed better performance over PCT at 48 h after admission in predicting one-month CPC (0.763 vs. 0.772, = 0.010). (4) Conclusions: Our findings suggest that PAR at 48 h after admission is more effective in predicting a one-month neurological outcome than PCT at 48 h after admission in patients with PCAS after OHCA.
（1）背景：心脏骤停后综合征（PCAS）是一种在自主循环恢复（ROSC）后发生的全身性缺血再灌注损伤。降钙素原与白蛋白比值（PAR）已被作为多种疾病的独立预后因素进行研究。此前尚无关于PCAS患者PAR的研究。我们评估了PAR在预测PCAS患者预后方面是否比降钙素原（PCT）更有效。（2）方法：这项回顾性队列研究共纳入了2016年1月至2020年12月期间187例非创伤性院外心脏骤停（OHCA）后发生PCAS的患者。进行多因素逻辑回归分析以评估PAR与PCAS预后之间的关联。通过受试者工作特征（ROC）分析和德龙检验比较PAR与PCT的预测性能。；（3）结果：入院后24小时和48小时的PAR与1个月时的神经功能结局独立相关（比值比：1.167，95%置信区间：1.023 - 1.330；比值比：1.077，95%置信区间：1.012 - 1.146，<0.05）。通过ROC分析，入院后48小时PAR在预测1个月时的脑功能分类（CPC）方面比PCT表现更好（0.763对0.772，=0.010）。（4）结论：我们的研究结果表明，对于OHCA后发生PCAS的患者，入院后48小时的PAR在预测1个月时的神经功能结局方面比入院后48小时的PCT更有效。
