Prognostic value of C-reactive protein to albumin ratio in patients resuscitated from out-of-hospital cardiac arrest

Int J Clin Pract. 2021 Jul;75(7):e14227. doi: 10.1111/ijcp.14227. Epub 2021 Apr 27.

Abstract

Background: Despite major advances in basic and advanced life supports, patients who survived from out-of-hospital cardiac arrest (OHCA) have 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 in-hospital mortality in patients with OHCA.

Methods: A total of 102 patients with OHCA were included in this study. The study population was divided into two groups as survivour (n = 43) and non-survivour (n = 59) during follow-up. Complete blood cell counts, biochemical and blood gas analyses 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 C-reactive protein to the albumin.

Results: NLR (P = .012), CAR (P < .001) and serum lactate level (P = .002) were significantly higher whereas lymphocyte (P = .008) and serum albumin (P < .001) were significantly lower in the non-survivour group compared with the survivour group. Multivariate logistic regression analysis showed that NLR (odds ratio [OR]: 1.044, 95% confidence interval [CI]: 1.044-1.437, P = .013), CAR (OR: 1.971, 95% CI: 1.327-2.930, P = .001) and lactate level (OR: 1.268, 95% CI: 1.095-1.469, P = .002) were independent predictors of in-hospital mortality.

Conclusions: We have demonstrated for the first time that CAR was an independent predictor of in-hospital mortality in OHCA patients.

MeSH terms

  • C-Reactive Protein*
  • Humans
  • Lymphocytes
  • Neutrophils
  • Out-of-Hospital Cardiac Arrest* / therapy
  • Prognosis
  • Retrospective Studies

Substances

  • C-Reactive Protein