Elevated serum osmolarity is associated with 28-day all-cause mortality in patients with cardiac arrest
10.5847/wjem.j.1920-8642.2026.009
- Author:
Ping Gong
1
Author Information
1. Department of Emergency, Shenzhen People's Hospital (Second Clinical Medical College, Jinan University)
- Publication Type:Journal Article
- Keywords:
Cardiac arrest;
Serum osmolarity;
High osmolarity;
Mortality
- From:
World Journal of Emergency Medicine
2026;17(1):50-56
- CountryChina
- Language:English
-
Abstract:
BACKGROUND: Serum osmolality is a prognostic indicator in critically ill patients. This study aimed to evaluate the association between high osmolality and 28-day mortality in patients with cardiac arrest (CA) admitted to the intensive care unit (ICU).
METHODS: Baseline data of adult patients with CA who were admitted to the ICU from 2008 to 2019 were collected from the Medical Information Mart for Intensive Care (MIMIC)-IV. Patients were divided into survivor and non-survivor groups according to the 28-day prognosis. Serum concentrations of sodium, potassium, glucose, and urea nitrogen on the first day of ICU admission were used to determine serum osmolarity. The primary endpoint of this study was 28-day all-cause mortality. Propensity score matching (PSM) analysis was performed to reduce bias between the survivor and non-survivor groups.
RESULTS: Among the 798 included CA patients, the high osmolarity on the first day of ICU admission remained significantly associated with increased 28-day mortality (62.0% vs. 35.5%, P<0.001) and reduced cumulative survival (log-rank P<0.05) after PSM. Cox regression identified the high osmolarity on the first day of ICU admission as an independent predictor. High serum osmolarity on the first day of ICU admission effectively predicted 1-, 3-, 7-, and 28-day all-cause mortality, with the strongest predictive performance for 1-day mortality both before and after PSM (all P<0.05).
CONCLUSION: In this study, elevated serum osmolarity on the first day of ICU admission was independently associated with increased 28-day mortality in CA patients and could serve as a prognostic marker.
