Prognostic value of CAR combined with CPR duration in patients with cardiac arrest
10.3760/cma.j.issn.1671-0282.2024.07.012
- VernacularTitle:CAR联合心肺复苏持续时间对心脏骤停患者预后的预测价值
- Author:
Yan ZHOU
1
;
Chao LAN
;
Ruyi LEI
;
Qiang ZHANG
;
Qing LYU
;
Tangjuan ZHANG
;
Xinya JIA
;
Renjie LI
Author Information
1. 郑州大学第一附属医院急诊医学科，河南省心肺脑复苏工程研究中心，郑州 450052
- Keywords:
Cardiac arrest;
Cardiopulmonary resuscitation;
C-reactive protein;
Albumin;
CPR duration;
Prognosis
- From:
Chinese Journal of Emergency Medicine
2024;33(7):955-962
- CountryChina
- Language:Chinese
-
Abstract:
Objective:Explore the predictive value of the C-reactive protein to albumin ratio (CAR) and combined indicators for the prognosis of cardiac arrest (CA) patients.Methods:Retrospective analysis was conducted on patients who recovered spontaneous circulation after cardiopulmonary resuscitation (CPR) admitted to the First Affiliated Hospital of Zhengzhou University from January 2021 to May 2023. Patients were divided into survival and non-survival groups based on their status at discharge. Baseline characteristics, CPR data, and laboratory indicators were compared between the two groups. Statistically significant indicators were further analyzed using multivariate logistic regression to identify independent risk factors affecting the prognosis of CA patients. Receiver operating characteristic (ROC) curves were constructed to assess the predictive value of each independent factor and combined indicators for the prognosis of CA patients.Results:A total of 145 patients were included in the study, including 33 patients in the survival group and 112 patients in the non-survival group. There were statistically significant differences between the survival group and the non-survival group in terms of CPR duration, the dosage of vasopressor drugs used, ICU length of stay, Acute Physiology and Chronic Health EvaluationⅡ (APACHEⅡ) score at ICU admission, lactate, fibrinogen, aspartate aminotransferase, albumin, procalcitonin, C-reactive protein, CAR, myoglobin, and creatine kinase isoenzyme (all P < 0.05). Multivariate logistic regression analysis revealed that CAR and CPR duration were independent risk factors affecting the prognosis of CA patients (CAR: OR=2.372, 95% CI: 1.094~5.146, P=0.029; CPR duration: OR=1.170, 95% CI: 1.020~1.342, P=0.025). ROC curve analysis showed that the areas under the curve for CAR, CPR duration, and their combination in predicting patient prognosis were 0.792, 0.731, and 0.859, respectively. The cut-off values for CAR and CPR duration were 1.455 and 11.5 minutes, respectively. Conclusions:The CAR and CPR duration are independent risk factors affecting the prognosis of CA patients, and the predictive value is higher when both CAR and CPR duration are combined. A CAR greater than 1.455 and a CPR duration longer than 11.5 minutes suggest a poorer prognosis for the patients.
