Abstract
Background: Early identification of risk factors for short-term mortality in patients with in-hospital cardiac arrest (IHCA) is crucial for early prognostication. This study aimed to explore the association of early dynamic changes in inflammatory markers with 30-day mortality in IHCA patients.Methods: This study retrospectively collected demographic and clinical characteristics and relevant laboratory indicators within 72 h after recovery of spontaneous circulation (ROSC) of IHCA patients from December 2015 to December 2020 at the First Affiliated Hospital of Chongqing Medical University. The outcome was 30-day mortality. A linear mixed model was used to analyze the dynamic changes in laboratory indicators within 72 h after ROSC, and Cox regression was used to identify the independent risk factors for 30-day mortality.Results: Overall, 85 IHCA patients were included. The 0-72h and 0-30day cumulative mortality rates were 25.88% and 57.65%, respectively, and the median survival time was 13.79 days. There was no association of inflammatory markers before IHCA with mortality. Within 72 h after ROSC, inflammatory markers showed various changes: the absolute monocyte count (AMC) showed no significant change trend, and the absolute lymphocyte count (ALC) showed an overall upward trend, while the absolute neutral count (ANC), white blood cell (WBC) count, platelet (PLT) count, neutrophil-lymphocyte ratio (NLR), platelet-lymphocyte ratio (PLR) and systemic immune-inflammation index (SII) showed an overall downward trend. Cox multivariate analysis showed that Charlson comorbidity index (CCI) (HR = 2.366, 95%CI (1.084, 5.168)), APACHE II score (HR = 2.550, 95% CI (1.001, 6.498)), abnormal Cr before IHCA (HR = 3.417, 95% CI (1.441, 8.104)) and PLR within 72 h after ROSC (HR = 2.993, 95% CI (1.442, 6.214)) were independent risk factors for 30-day mortality. When PLR ≥ 180, the risk of 30-day mortality increased by 199.3%.Conclusions: This study clarified the dynamic change trends of inflammatory markers within 72 h after ROSC. The PLR was an independent risk factor for 30-day mortality in IHCA patients; it can be used as a predictor of short-term mortality and provide a reference for early prognostication.Trial registration: ChiCTR1800014324
Risk Factors for Non-Neurological Complications in Adult Spinal Deformity Surgery: An International, Large-Scale, Prospective Multicenter Study
