Lee Sang Hwan, Cho Yongil, Oh Jaehoon, Kang Hyunggoo, Lim Tae Ho, Ko Byuk Sung, Yoo Kyung Hun, Lee Juncheol
Department of Emergency Medicine, College of Medicine, Hanyang University, 222-1 Wangsimni-ro, Seongdong-gu, Seoul, 04763, Republic of Korea.
Intern Emerg Med. 2025 Jun;20(4):1185-1193. doi: 10.1007/s11739-024-03742-0. Epub 2024 Nov 8.
Assessing the neurologic outcomes of patients who experience out of hospital cardiac arrest (OHCA) is challenging. Neurologic outcomes were evaluated using initial nutrition related biochemical markers.
We used data from a multicentre retrospective observational study, the Korean Cardiac Arrest Resuscitation Consortium (KoCARC) registry. Among the 666 patients, 217 had good neurologic outcomes, while 449 had poor neurologic outcomes. Multivariate logistic regression and classification and regression tree (CART) analyses were employed.
In the multivariate logistic regression analysis, total cholesterol ≥ 158.5 mg/dL, total bilirubin ≥ 0.265 mg/dL, Sodium < 142.1 mEq/L, AST < 200.5 U/L and were identified as significant biomarkers for good neurologic outcomes. In the CART analysis, total cholesterol ≥ 158.5 mg/dL and total bilirubin ≥ 0.365 mg/dL were found to be significant indicators. In additional analysis, when the total bilirubin level ranged from 0.6 to 0.7 mg/dL, the highest rate of a good neurologic outcome was observed at 44.6%, whereas levels below or above this range gradually indicated a lower rate of a good neurologic outcome.
We propose that total cholesterol and total bilirubin levels could serve as valuable indicators for predicting neurologic outcomes in patients with OHCA.
评估院外心脏骤停(OHCA)患者的神经学预后具有挑战性。使用初始营养相关生化标志物评估神经学预后。
我们使用了来自多中心回顾性观察研究——韩国心脏骤停复苏联盟(KoCARC)登记处的数据。在666例患者中,217例神经学预后良好,449例神经学预后不良。采用多因素逻辑回归和分类回归树(CART)分析。
在多因素逻辑回归分析中,总胆固醇≥158.5mg/dL、总胆红素≥0.265mg/dL、钠<142.1mEq/L、谷草转氨酶<200.5U/L被确定为神经学预后良好的重要生物标志物。在CART分析中,总胆固醇≥158.5mg/dL和总胆红素≥0.365mg/dL被发现是重要指标。在进一步分析中,当总胆红素水平在0.6至0.7mg/dL之间时,观察到神经学预后良好的最高发生率为44.6%,而低于或高于此范围的水平逐渐显示神经学预后良好的发生率较低。
我们提出总胆固醇和总胆红素水平可作为预测OHCA患者神经学预后的有价值指标。