The neuro-prognostic value of the ion shift index in cardiac arrest patients following extracorporeal cardiopulmonary resuscitation
Gannan Wang, Zhe Wang, Yi Zhu, Zhongman Zhang, Wei Li, Xufeng Chen, Yong Mei
Table 1. Clinical and laboratory characteristics of enrolled patients
Characteristics Favorable neurological outcome (n=34) Unfavorable neurological outcome (n=88) t/χ2/Z P-value
Age, years, mean±SD 52.35±14.76 49.28±17.02 0.925 0.357
Male, n (%) 22 (64.7) 67 (76.1) 1.624 0.203
Comorbidities, n (%)
Hypertension 14 (41.2) 30 (34.1) 0.534 0.465
Diabetes 8 (23.5) 17 (19.3) 0.267 0.605
Coronary artery disease 2 (5.9) 8 (9.1) 0.045 0.833
OHCA, n (%) 7 (20.6) 39 (44.3) 5.880 0.015
Witnessed, n (%) 34 (100) 80 (90.9) 1.991 0.158
Bystander CPR, n (%) 34 (100) 73 (83.0) 5.122 0.024
Cardiac etiology, n (%) 27 (79.4) 68 (77.3) 0.065 0.799
Initial non-shockable rhythm, n (%) 23 (67.6) 44 (50.0) 3.085 0.079
Resuscitation duration, min, median (IQR) 40.5 (17.5-55.0) 50.0 (34.0-82.3) -2.639 0.008
ECMO duration, h, median (IQR) 141.5 (122.8-187.8) 94.4 (49.3-169.3) -3.278 0.001
Length of stay in hospital, d, median (IQR) 19 (15-27) 5 (3-11) -6.609 <0.001
GCS score after ECPR, median (IQR) 9 (8-12) 3 (3-4) -7.765 <0.001
Prognostic predictors
GCS-M ≤2, n (%) 5 (14.7) 81 (92.0) 70.522 <0.001
Pupillary/corneal reflex absence, n (%) 0 (0) 51 (58.0) 33.859 <0.001
GWR-basal ganglia, median (IQR) 1.25 (1.20-1.27) 1.14 (1.08-1.19) -5.977 <0.001
NSE, ng/mL, median (IQR) 44.6 (38.3-60.7) 188.5 (88.1-370.0) -6.972 <0.001
Laboratory parameters, median (IQR)
Hemoglobin, g/L 116.5 (101.0-132.3) 111.0 (84.0-129.0) -1.385 0.166
pH 7.41 (7.31-7.52) 7.22 (6.96-7.36) -4.046 <0.001
Lactate, mmol/L 3.1 (1.1-11.5) 10.2 (4.0-15.6) -2.854 0.004
Glucose, mmol/L 9.5 (6.7-11.7) 10.1 (7.1-13.5) -0.504 0.614
Albumin, g/L 33.8 (30.3-39.3) 31.8 (26.5-39.2) -1.008 0.313
ALT, U/L 159.0 (102.1-309.6) 306.1 (120.5-801.5) -2.438 0.015
Aspartate aminotransferase, U/L 420.3 (170.1-932.0) 926.7 (364.6-2176.5) -2.889 0.004
Total bilirubin, μmol/L 14.0 (10.8-19.9) 20.1 (13.1-32.2) -2.204 0.028
Creatinine, μmol/L 96.1 (69.0-137.7) 76.5 (103.2-148.2) -1.074 0.283
Potassium, mmol/L 3.9 (3.6-4.3) 4.5 (3.8-5.2) -3.489 <0.001
Magnesium, mmol/L 0.9 (0.8-1.0) 1.0 (0.9-1.1) -1.994 0.046
Phosphate, mmol/L 1.0 (0.7-1.2) 1.2 (0.8-2.1) -2.778 0.005
Calcium, mmol/L 2.1 (2.0-2.2) 1.9 (1.6-2.1) -3.907 <0.001
Ion shift index 2.69 (2.51-3.07) 3.74 (3.15-4.57) -6.504 <0.001