ABSTRACT
Background: Despite major advances in basic and advanced life
supports, patients who survived from out of hospital cardiac arrest
(OHCA) has still poor prognosis. Several inflammatory parameters have
been used to determine early and long-term prognosis in patients with
OHCA. C-reactive protein-to-albumin ratio (CAR) is also a novel marker
of systemic inflammation. To our knowledge, there is no study evaluating
the clinical importance of CAR in OHCA patients.
Aims: To evaluate the effect of CAR on mortality in patients
with OHCA.
Methods: A total of 102 patients with OHCA were included in
this study. The study population were divided into two groups as
survivor (n = 43) and non-survivor (n = 59) during follow-up. Complete
blood cell counts, biochemical and blood gas analysis were recorded for
all patients. Neutrophil to lymphocyte ratio (NLR) was calculated as the
ratio of neutrophil to lymphocyte. CAR was calculated as the ratio of
CRP to the albumin.
Results: NLR (P=0.012), CAR (P<0.001) and serum
lactate level (P =0.002) were significantly higher whereas lymphocyte
(P=0.008) and serum albumin (P<0.001) were significantly lower
in non-survivor group compared to survivor group. Multivariate logistic
regression analysis showed that NLR (odds ratio [OR]: 1.044, 95%
confidence interval [CI]: 1.044-1.437, P=0.013), CAR (OR: 1.971,
95% CI: 1.327-2.930, P=0.001), and lactate level (OR: 1.268, 95% CI:
1.095-1.469, P=0.002) were independent predictors of mortality.
Conclusions: We have demonstrated for the first time that CAR
was an independent predictor of in-hospital mortality in OHCA patients.
Keywords: Out of hospital cardiac arrest, systemic
inflammation, neutrophil to lymphocyte ratio, C-reactive protein to
albumin ratio, mortality.