Zhenyu Shan, Xingsheng Wang, Le An, Chenchen Hang, Zihao Jiang, Weijie Cheng, Ziqi Zhong, Rui Shao, Ziren Tang
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Difference test, restricted cubic spline, and correlation analysis were used to analyze the correlation between humoral immunity and outcomes.</p><p><strong>Results: </strong>Differences were observed in IgM, C3, and C4 levels among patients with different prognoses. Patients with poor prognosis have lower IgM levels (CPC 1-2 vs. CPC 3-5: 68.3[47.05-105] vs. 55.45[31.95-86.12] mg/dL, P = 0.0256), lower C3 levels (CPC 1-2 vs. CPC 3-5: 72.1[62.6-72.1] vs. 63.05[49.83-79.72] mg/dL, P = 0.0091; survival vs. dead: 72.1[60.9-86.62] vs. 58.7[43.7-72.6] mg/dL, P < 0.0001), and lower C4 levels (survival vs. dead: 18.9[15.38-22.92] vs. 17.2[11.85-21.5] mg/dL, P = 0.0148). Non-linear correlations were found between humoral immunity and prognosis (IgM: OR<sub>non-linear</sub>=1.068[95%CI: 1.009-1.130], P<sub>non-linear</sub>=0.0236); C3: OR<sub>non-linear</sub>=1.048[95%CI: 1.000-1.097], P<sub>non-linear</sub>=0.0488). LOS was negatively linearly correlated with IgG (R<sup>2</sup><sub>adjusted</sub> = 0.115, P = 0.0148) and C3 (R<sup>2</sup><sub>adjusted</sub> = 0.127, P = 0.0108) in patients with CPC 1-2.</p><p><strong>Conclusions: </strong>Humoral immunity is at a low level in OHCA patients after ROSC, and humoral immunity was associated with neurological prognosis, survival at discharge, and LOS.</p>","PeriodicalId":9002,"journal":{"name":"BMC Emergency Medicine","volume":"25 1","pages":"124"},"PeriodicalIF":2.3000,"publicationDate":"2025-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12261566/pdf/","citationCount":"0","resultStr":"{\"title\":\"Association between humoral immunity and clinical outcomes of patients after out-of-hospital cardiac arrest and resuscitation: a retrospective study.\",\"authors\":\"Zhenyu Shan, Xingsheng Wang, Le An, Chenchen Hang, Zihao Jiang, Weijie Cheng, Ziqi Zhong, Rui Shao, Ziren Tang\",\"doi\":\"10.1186/s12873-025-01282-0\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>Patients with out-of-hospital cardiac arrest (OHCA) suffer from hypoxia-ischemia and ischemia-reperfusion injury (IRI) after the return of spontaneous circulation (ROSC). The impact of early humoral immunity on prognosis in this process remains unclear.</p><p><strong>Methods: </strong>Outcomes at discharge were evaluated in 183 patients resuscitated from OHCA, including neurological outcomes as measured by CPC scores, survival, and length of stay (LOS). Humoral immunity, including IgG, IgA, IgM, C3, and C4, was tested on the first day of admission. Difference test, restricted cubic spline, and correlation analysis were used to analyze the correlation between humoral immunity and outcomes.</p><p><strong>Results: </strong>Differences were observed in IgM, C3, and C4 levels among patients with different prognoses. Patients with poor prognosis have lower IgM levels (CPC 1-2 vs. CPC 3-5: 68.3[47.05-105] vs. 55.45[31.95-86.12] mg/dL, P = 0.0256), lower C3 levels (CPC 1-2 vs. CPC 3-5: 72.1[62.6-72.1] vs. 63.05[49.83-79.72] mg/dL, P = 0.0091; survival vs. dead: 72.1[60.9-86.62] vs. 58.7[43.7-72.6] mg/dL, P < 0.0001), and lower C4 levels (survival vs. dead: 18.9[15.38-22.92] vs. 17.2[11.85-21.5] mg/dL, P = 0.0148). Non-linear correlations were found between humoral immunity and prognosis (IgM: OR<sub>non-linear</sub>=1.068[95%CI: 1.009-1.130], P<sub>non-linear</sub>=0.0236); C3: OR<sub>non-linear</sub>=1.048[95%CI: 1.000-1.097], P<sub>non-linear</sub>=0.0488). LOS was negatively linearly correlated with IgG (R<sup>2</sup><sub>adjusted</sub> = 0.115, P = 0.0148) and C3 (R<sup>2</sup><sub>adjusted</sub> = 0.127, P = 0.0108) in patients with CPC 1-2.</p><p><strong>Conclusions: </strong>Humoral immunity is at a low level in OHCA patients after ROSC, and humoral immunity was associated with neurological prognosis, survival at discharge, and LOS.</p>\",\"PeriodicalId\":9002,\"journal\":{\"name\":\"BMC Emergency Medicine\",\"volume\":\"25 1\",\"pages\":\"124\"},\"PeriodicalIF\":2.3000,\"publicationDate\":\"2025-07-15\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12261566/pdf/\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"BMC Emergency Medicine\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1186/s12873-025-01282-0\",\"RegionNum\":3,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q1\",\"JCRName\":\"EMERGENCY MEDICINE\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"BMC Emergency Medicine","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1186/s12873-025-01282-0","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"EMERGENCY MEDICINE","Score":null,"Total":0}
引用次数: 0
摘要
背景：院外心脏骤停（OHCA）患者在恢复自发循环（ROSC）后发生缺氧缺血和缺血再灌注损伤（IRI）。在此过程中，早期体液免疫对预后的影响尚不清楚。方法：对183例OHCA复苏患者出院时的预后进行评估，包括以CPC评分、生存率和住院时间（LOS）衡量的神经系统预后。入院第一天检测体液免疫，包括IgG、IgA、IgM、C3和C4。采用差异检验、受限三次样条和相关分析分析体液免疫与预后的相关性。结果：不同预后患者IgM、C3、C4水平存在差异。预后差的患者IgM水平较低（CPC 1-2 vs CPC 3-5: 68.3[47.05-105] vs 55.45[31.95-86.12] mg/dL, P = 0.0256）， C3水平较低(CPC 1-2 vs CPC 3-5: 72.1[62.6-72.1] vs 63.05[49.83-79.72] mg/dL, P = 0.0091；存活vs.死亡：72.1[60.9 ~ 86.62]vs. 58.7[43.7 ~ 72.6] mg/dL， P非线性=1.068[95%CI: 1.009 ~ 1.130]， P非线性=0.0236)；C3: or非线性=1.048[95%CI: 1.000 ~ 1.097]， p非线性=0.0488)。在CPC 1-2患者中，LOS与IgG （r2校正= 0.115,P = 0.0148）、C3 （r2校正= 0.127,P = 0.0108）呈线性负相关。结论：ROSC后OHCA患者体液免疫水平较低，体液免疫与神经预后、出院生存和LOS相关。
Association between humoral immunity and clinical outcomes of patients after out-of-hospital cardiac arrest and resuscitation: a retrospective study.
Background: Patients with out-of-hospital cardiac arrest (OHCA) suffer from hypoxia-ischemia and ischemia-reperfusion injury (IRI) after the return of spontaneous circulation (ROSC). The impact of early humoral immunity on prognosis in this process remains unclear.
Methods: Outcomes at discharge were evaluated in 183 patients resuscitated from OHCA, including neurological outcomes as measured by CPC scores, survival, and length of stay (LOS). Humoral immunity, including IgG, IgA, IgM, C3, and C4, was tested on the first day of admission. Difference test, restricted cubic spline, and correlation analysis were used to analyze the correlation between humoral immunity and outcomes.
Results: Differences were observed in IgM, C3, and C4 levels among patients with different prognoses. Patients with poor prognosis have lower IgM levels (CPC 1-2 vs. CPC 3-5: 68.3[47.05-105] vs. 55.45[31.95-86.12] mg/dL, P = 0.0256), lower C3 levels (CPC 1-2 vs. CPC 3-5: 72.1[62.6-72.1] vs. 63.05[49.83-79.72] mg/dL, P = 0.0091; survival vs. dead: 72.1[60.9-86.62] vs. 58.7[43.7-72.6] mg/dL, P < 0.0001), and lower C4 levels (survival vs. dead: 18.9[15.38-22.92] vs. 17.2[11.85-21.5] mg/dL, P = 0.0148). Non-linear correlations were found between humoral immunity and prognosis (IgM: ORnon-linear=1.068[95%CI: 1.009-1.130], Pnon-linear=0.0236); C3: ORnon-linear=1.048[95%CI: 1.000-1.097], Pnon-linear=0.0488). LOS was negatively linearly correlated with IgG (R2adjusted = 0.115, P = 0.0148) and C3 (R2adjusted = 0.127, P = 0.0108) in patients with CPC 1-2.
Conclusions: Humoral immunity is at a low level in OHCA patients after ROSC, and humoral immunity was associated with neurological prognosis, survival at discharge, and LOS.
期刊介绍：
BMC Emergency Medicine is an open access, peer-reviewed journal that considers articles on all urgent and emergency aspects of medicine, in both practice and basic research. In addition, the journal covers aspects of disaster medicine and medicine in special locations, such as conflict areas and military medicine, together with articles concerning healthcare services in the emergency departments.
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