Prognostic Value of C-Reactive Protein to Albumin Ratio in Patients
Resuscitated from Out-of-Hospital Cardiac Arrest
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.