World Journal of Emergency Medicine ›› 2024, Vol. 15 ›› Issue (3): 223-228.doi: 10.5847/wjem.j.1920-8642.2024.037
• Research Letters • Previous Articles Next Articles
Ji Ho Lee1, Dong Hun Lee1,2(
), Byung Kook Lee1,2, Seok Jin Ryu1
Received:2023-11-06
Accepted:2024-02-12
Online:2024-05-15
Published:2024-05-01
Contact:
Dong Hun Lee, Email: Ji Ho Lee, Dong Hun Lee, Byung Kook Lee, Seok Jin Ryu. The association between C-reactive protein to albumin ratio and 6-month neurological outcome in patients with in-hospital cardiac arrest[J]. World Journal of Emergency Medicine, 2024, 15(3): 223-228.
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URL: http://wjem.com.cn/EN/10.5847/wjem.j.1920-8642.2024.037
Table 1.
Comparisons of baseline characteristics according to neurological outcomes at 6 months
| Variables | Total (n=141) | Favorable (n=29) | Poor (n=112) | P-value |
|---|---|---|---|---|
| Demographics | ||||
| Age, years | 68.0 (58.0-76.5) | 59.2 (52.0-70.5) | 70.0 (60.0-78.5) | 0.003 |
| Male, n (%) | 84 (59.6) | 14 (48.3) | 70 (62.5) | 0.238 |
| Body mass index, kg/m2 | 23.3 (20.7-26.0) | 23.4 (20.7-25.3) | 23.1 (20.6-26.0) | 0.925 |
| Preexisting illness, n (%) | ||||
| Coronary artery disease | 21 (14.9) | 3 (10.3) | 18 (16.1) | 0.632 |
| Congestive heart failure | 27 (19.1) | 3 (10.3) | 24 (21.4) | 0.277 |
| Hypertension | 84 (59.6) | 17 (58.6) | 67 (59.8) | 1.000 |
| Diabetes | 55 (39.0) | 10 (34.5) | 45 (40.2) | 0.729 |
| Chronic lung disease | 20 (14.2) | 5 (17.2) | 15 (13.4) | 0.817 |
| Renal impairment | 26 (18.4) | 3 (10.3) | 23 (20.5) | 0.321 |
| Liver cirrhosis | 4 (2.8) | 0 (0.0) | 4 (3.6) | 0.685 |
| Cerebrovascular accident | 18 (12.8) | 2 (6.9) | 16 (14.3) | 0.453 |
| Malignancy | 14 (9.9) | 5 (17.2) | 9 (8.0) | 0.259 |
| Cardiac arrest characteristics | ||||
| Witnessed collapse, n (%) | 120 (85.1) | 27 (93.1) | 93 (83.0) | 0.287 |
| Shockable rhythm, n (%) | 34 (24.1) | 11 (37.9) | 23 (20.5) | 0.088 |
| Presumed cardiac cause, n (%) | 56 (39.7) | 15 (51.7) | 41 (36.6) | 0.204 |
| Time to ROSC, min | 15.0 (7.0-23.5) | 10.0 (5.0-15.0) | 15.0 (10.0-29.8) | 0.004 |
| GO-FAR score | 6 (-4-13) | -3 (-11-3) | 9 (0-13) | <0.001 |
| Clinical characteristics after ROSC | ||||
| Lactate, mmol/L | 7.3 (4.0-12.5) | 7.4 (4.6-11.8) | 7.2 (3.9-13.3) | 0.712 |
| Glucose, mg/dL | 204 (140-299) | 236 (145-312) | 203 (137-294) | 0.461 |
| PaO2, mmHg | 178.0 (87.5-310.5) | 274.0 (114.0-363.0) | 144.0 (83.8-251.5) | 0.073 |
| PaCO2, mmHg | 41.0 (29.0-58.0) | 41.0 (27.5-53.1) | 41.5 (29.0-58.0) | 0.394 |
| CRP, mg/dL | 1.4 (0.2-8.6) | 0.2 (0.0-1.2) | 2.4 (0.4-10.8) | <0.001 |
| Albumin, g/dL | 3.1 (2.6-3.4) | 3.4 (3.0-3.8) | 3.0 (2.5-3.3) | <0.001 |
| CAR | 0.5 (0.1-3.0) | 0.0 (0.0-0.4) | 0.9 (0.1-3.5) | <0.001 |
Table 2.
Multivariate logistic regression analysis for poor neurological outcomes at 6 months
| Variables | Unadjusted OR (95% CI) | P-value | Adjusted OR (95% CI) | P-value |
|---|---|---|---|---|
| Shockable rhythm | 0.423 (0.176-1.019) | 0.055 | 0.432 (0.116-1.611) | 0.211 |
| Time to ROSC, min | 1.052 (1.006-1.099) | 0.025 | 1.084 (1.031-1.140) | 0.002 |
| GO-FAR score | 1.134 (1.075-1.197) | <0.001 | 1.175 (1.096-1.261) | <0.001 |
| PaO2, mmHg | 0.999 (0.996-1.002) | 0.083 | 0.997 (0.993-1.001) | 0.162 |
| CAR | 1.804 (1.157-2.812) | 0.009 | 1.851 (1.213-2.824) | 0.004 |
Table 3.
ROC analysis of time to ROSC, GO-FAR score, and CAR for poor neurological outcomes at 6 months
| Variables | AUC (95% CI) | P-value | Cutoff value | Sensitivity (95% CI) | Specificity (95% CI) | PPV (95% CI) | NPV (95% CI) |
|---|---|---|---|---|---|---|---|
| Time to ROSC, min | 0.672 (0.588-0.749) | 0.003 | >11 | 66.1 (56.5-74.7) | 62.1 (42.3-79.3) | 87.1 (80.6-91.6) | 32.1 (24.4-41.0) |
| GO-FAR score | 0.789 (0.712-0.853) | <0.001 | >-1 | 75.9 (66.9-83.5) | 72.4 (52.8-87.3) | 91.4 (85.4-95.1) | 43.7 (34.3-53.7) |
| CAR | 0.774 (0.696-0.840) | <0.001 | >0.1 | 73.2 (64.0-81.1) | 69.0 (49.2-84.7) | 90.1 (84.0-94.1) | 40.0 (31.1-49.7) |
| CRP, mg/dL | 0.761 (0.682-0.829) | <0.001 | >0.6 | 65.2 (55.6-73.9) | 75.9 (56.5-89.7) | 91.3 (84.4-95.3) | 36.1 (28.9-43.9) |
| Albumin, g/dL | 0.714 (0.632-0.787) | <0.001 | ≤3.3 | 79.5 (70.8-86.5) | 62.1 (42.3-79.3) | 89.0 (83.4-92.9) | 43.9 (33.0-55.4) |
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