Xiao Linlin, Li Feng, Sheng Yuanhui, Hou Xueping, Liao Xixi, Zhou Pengfei, Qin Yuping, Chen Xiaoying, Liu Jinglun, Luo Yetao, Peng Dong, Xu Shan, Zhang Dan
Department of Critical Care Medicine & Department of Emergency, The First Affiliated Hospital of Chongqing Medical University, Chongqing, People's Republic of China.
Department of Neurology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, People's Republic of China.
Expert Rev Clin Immunol. 2025 Feb;21(2):249-257. doi: 10.1080/1744666X.2024.2399700. Epub 2024 Sep 4.
This study investigated the predictive value of albumin-related inflammatory markers for short-term outcomes in in-hospital cardiac arrest (IHCA) patients.
A linear mixed model investigated the dynamic changes of markers within 72 hours after return of spontaneous circulation (ROSC). Time-Dependent COX regression explored the predictive value. Mediation analysis quantified the association of markers with organ dysfunctions and adverse outcomes.
Prognostic Nutritional Index (PNI) and RDW-Albumin Ratio (RAR) slightly changed ( > 0.05). Procalcitonin-Albumin Ratio (PAR1) initially increased and then slowly decreased. Neutrophil-Albumin Ratio (NAR) and Platelet-Albumin Ratio (PAR2) decreased slightly during 24-48 hours (all p<0.05). PNI (HR = 1.646, 95%CI (1.033,2.623)), PAR1 (HR = 1.69, 95%CI (1.057,2.701)), RAR (HR = 1.752,95%CI (1.103,2.783)) and NAR (HR = 1.724,95%CI (1.078,2.759)) were independently associated with in-hospital mortality. PNI (PM = 45.64%, 95%CI (17.05%,87.02%)), RAR (PM = 45.07%,95%CI (14.59%,93.70%)) and NAR (PM = 46.23%,95%CI (14.59%,93.70%)) indirectly influenced in-hospital mortality by increasing SOFA (central) scores. PNI (PM = 21.75%, 95%CI(0.67%,67.75%)) may also indirectly influenced outcome by increasing SOFA (renal) scores (all p < 0.05).
Within 72 hours after ROSC, albumin-related inflammatory markers (PNI, PAR1, RAR, and NAR) were identified as potential predictors of short-term prognosis in IHCA patients. They may mediate the adverse outcomes of patients by causing damages to the central nervous system and renal function.
本研究调查了白蛋白相关炎症标志物对院内心脏骤停（IHCA）患者短期预后的预测价值。
采用线性混合模型研究自主循环恢复（ROSC）后72小时内标志物的动态变化。时间依赖性COX回归分析探索预测价值。中介分析量化标志物与器官功能障碍和不良结局之间的关联。
预后营养指数（PNI）和红细胞分布宽度-白蛋白比值（RAR）变化轻微（>0.05）。降钙素原-白蛋白比值（PAR1）最初升高，随后缓慢下降。中性粒细胞-白蛋白比值（NAR）和血小板-白蛋白比值（PAR2）在24 - 48小时内略有下降（均p<0.05）。PNI（HR = 1.646，95%CI（1.033，2.623））、PAR1（HR = 1.69，95%CI（1.057，2.701））、RAR（HR = 1.752，95%CI（1.103，2.783））和NAR（HR = 1.724，95%CI（1.078，2.759））与院内死亡率独立相关。PNI（PM = 45.64%，95%CI（17.05%，87.02%））、RAR（PM = 45.07%，95%CI（14.59%，93.70%））和NAR（PM = 46.23%，95%CI（14.59%，93.70%））通过增加序贯器官衰竭评估（SOFA）（中枢）评分间接影响院内死亡率。PNI（PM = 21.75%，95%CI（0.67%，67.75%））也可能通过增加SOFA（肾脏）评分间接影响结局（均p<0.05）。
ROSC后72小时内，白蛋白相关炎症标志物（PNI、PAR1、RAR和NAR）被确定为IHCA患者短期预后的潜在预测指标。它们可能通过损害中枢神经系统和肾功能介导患者的不良结局。
