Predictive value analysis of albumin-related inflammatory markers for short-term outcomes in patients with In-hospital cardiac arrest.

IF 3.9 3区医学 Q2 IMMUNOLOGY

Expert Review of Clinical Immunology Pub Date : 2024-09-04 DOI:10.1080/1744666X.2024.2399700

Linlin Xiao, Feng Li, Yuanhui Sheng, Xueping Hou, Xixi Liao, Pengfei Zhou, Yuping Qin, Xiaoying Chen, Jinglun Liu, Yetao Luo, Dong Peng, Shan Xu, Dan Zhang

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引用次数: 0

Abstract

Objective: This study investigated the predictive value of albumin-related inflammatory markers for short-term outcomes in in-hospital cardiac arrest (IHCA) patients.

Methods: A linear mixed model investigated the dynamic changes of markers within 72 hours after return of spontaneous circulation (ROSC). Time-Dependent COX regression explored the predictive value. Mediation analysis quantified the association of markers with organ dysfunctions and adverse outcomes.

Results: Prognostic Nutritional Index (PNI) and RDW-Albumin Ratio (RAR) slightly changed (p > 0.05). Procalcitonin-Albumin Ratio (PAR1) initially increased and then slowly decreased. Neutrophil-Albumin Ratio (NAR) and Platelet-Albumin Ratio (PAR2) decreased slightly during 24-48 hours (all p<0.05). PNI (HR = 1.646, 95%CI (1.033,2.623)), PAR1 (HR = 1.69, 95%CI (1.057,2.701)), RAR (HR = 1.752,95%CI (1.103,2.783)) and NAR (HR = 1.724,95%CI (1.078,2.759)) were independently associated with in-hospital mortality. PNI (PM = 45.64%, 95%CI (17.05%,87.02%)), RAR (PM = 45.07%,95%CI (14.59%,93.70%)) and NAR (PM = 46.23%,95%CI (14.59%,93.70%)) indirectly influenced in-hospital mortality by increasing SOFA (central) scores. PNI (PM = 21.75%, 95%CI(0.67%,67.75%)) may also indirectly influenced outcome by increasing SOFA (renal) scores (all p < 0.05).

Conclusions: Within 72 hours after ROSC, albumin-related inflammatory markers (PNI, PAR1, RAR, and NAR) were identified as potential predictors of short-term prognosis in IHCA patients. They may mediate the adverse outcomes of patients by causing damages to the central nervous system and renal function.

查看原文本刊更多论文

白蛋白相关炎症指标对院内心脏骤停患者短期预后的预测价值分析。

目的本研究探讨了白蛋白相关炎症指标对院内心脏骤停（IHCA）患者短期预后的预测价值：方法：线性混合模型研究了自发性循环恢复（ROSC）后 72 小时内指标的动态变化。时间依赖性 COX 回归探讨了预测价值。中介分析量化了指标与器官功能障碍和不良预后的关联：结果：预后营养指数（PNI）和RDW-白蛋白比值（RAR）略有变化（P > 0.05）。降钙素原-白蛋白比值（PAR1）最初上升，然后缓慢下降。中性粒细胞-白蛋白比率（NAR）和血小板-白蛋白比率（PAR2）在 24-48 小时内略有下降（均 p＜0.05）。PNI（HR = 1.646，95%CI (1.033,2.623)）、PAR1（HR = 1.69，95%CI (1.057,2.701)）、RAR（HR = 1.752，95%CI (1.103,2.783)）和 NAR（HR = 1.724，95%CI (1.078,2.759)）与院内死亡率独立相关。PNI（PM = 45.64%，95%CI (17.05%,87.02%)）、RAR（PM = 45.07%，95%CI (14.59%,93.70%)）和 NAR（PM = 46.23%，95%CI (14.59%,93.70%)）通过增加 SOFA（中心）评分间接影响院内死亡率。PNI（PM = 21.75%，95%CI(0.67%,67.75%)）也可能通过增加SOFA（肾脏）评分间接影响预后（所有P＜0.05）：结论：在复苏后 72 小时内，白蛋白相关炎症标志物（PNI、PAR1、RAR 和 NAR）被确定为 IHCA 患者短期预后的潜在预测因子。它们可能会对中枢神经系统和肾功能造成损害，从而影响患者的不良预后。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Expert Review of Clinical Immunology IMMUNOLOGY-

CiteScore

7.60

自引率

2.30%

发文量

221

审稿时长

6-12 weeks

期刊介绍： Expert Review of Clinical Immunology (ISSN 1744-666X) provides expert analysis and commentary regarding the performance of new therapeutic and diagnostic modalities in clinical immunology. Members of the International Editorial Advisory Panel of Expert Review of Clinical Immunology are the forefront of their area of expertise. This panel works with our dedicated editorial team to identify the most important and topical review themes and the corresponding expert(s) most appropriate to provide commentary and analysis. All articles are subject to rigorous peer-review, and the finished reviews provide an essential contribution to decision-making in clinical immunology. Articles focus on the following key areas: • Therapeutic overviews of specific immunologic disorders highlighting optimal therapy and prospects for new medicines • Performance and benefits of newly approved therapeutic agents • New diagnostic approaches • Screening and patient stratification • Pharmacoeconomic studies • New therapeutic indications for existing therapies • Adverse effects, occurrence and reduction • Prospects for medicines in late-stage trials approaching regulatory approval • Novel treatment strategies • Epidemiological studies • Commentary and comparison of treatment guidelines Topics include infection and immunity, inflammation, host defense mechanisms, congenital and acquired immunodeficiencies, anaphylaxis and allergy, systemic immune diseases, organ-specific inflammatory diseases, transplantation immunology, endocrinology and diabetes, cancer immunology, neuroimmunology and hematological diseases.