ObjectiveTo explore the value of platelet-lymphocyte ratio (PLR) after return of spontaneous circulation (ROSC) combined with Sequential Organ Failure Assessment (SOFA) for estimating the short-term prognosis of ROSC patients suffered from in-hospital cardiac arrest (IHCA).MethodsROSC adult patients who suffered from IHCA during treatment in the Emergency Department of West China Hospital of Sichuan University between 00:00, August 1st, 2010 and 23:59, July 31st, 2018 were included retrospectively. The basic and clinical data of patients were collected. Patients were divided into survival group and death group according to the 28-day prognosis. Through logistic regression and receiver operating characteristic (ROC) curve analysis, the efficacy of PLR after ROSC combined with SOFA score in predicting the 28-day prognosis of IHCA patients was explored.ResultsA total of 199 patients were included, including 135 males and 64 females, with a mean age of (60.45±17.52) years old. There were 154 deaths and 45 survivors within 28 days. There were statistically significant differences between the survival group and the death group in terms of epinephrine dosage, SOFA score, proportion of patients complicated with respiratory diseases, and post-ROSC laboratory indexes including PLR, hemoglobin, red blood cell count, lymphocyte count, indirect bilirubin, serum albumin, cholesterol, and activated partial thrombin time (P<0.05). The result of multivariate logistic regression analysis showed that epinephrine dosage [odds ratio (OR)=1.177, 95% confidence interval (CI) (1.024, 1.352), P=0.022], SOFA score [OR=1.536, 95%CI (1.173, 2.010), P=0.002], PLR after ROSC [OR=1.011, 95%CI (1.004, 1.018), P=0.002] were independent risk factors for ROSC patients’ death on day 28. The areas under the ROC curve of epinephrine dosage, SOFA score and PLR after ROSC were 0.702, 0.703 and 0.737, respectively, to predict the patients’ 28-day outcome. Combining the epinephrine dosage and PLR after ROSC with SOFA score respectively to predict the 28-day outcome of patients, the areas under the ROC curve were 0.768 and 0.813, respectively.ConclusionsThe significant increase of PLR after ROSC is an independent risk factor for death within 28 days after ROSC. The combined application of PLR after ROSC and SOFA score in the 28-day outcome prediction of patients has better predictive efficacy.
Objective To investigate the relationship between thrombocytopenia after the restoration of spontaneous circulation and short-term prognosis of patients with in-hospital cardiac arrest. Methods The demographic data, post-resuscitation vital signs, post-resuscitation laboratory tests, and the 28-day mortality rate of patients who experienced in-hospital cardiac arrest at the Emergency Department of West China Hospital, Sichuan University between January 1st, 2016 and December 31st, 2016 were retrospectively analyzed. Logistic regression was used to analyze the correlation between thrombocytopenia after the return of spontaneous circulation and the 28-day mortality rate in these cardiac arrest patients. Results Among the 285 patients included, compared with the normal platelet group (n=130), the thrombocytopenia group (n=155) showed statistically significant differences in red blood cell count, hematocrit, white blood cell count, prothrombin time, activated partial thromboplastin time, and international normalized ratio (P<0.05). The 28-day mortality rate was higher in the thrombocytopenia group than that in the normal platelet group (84.5% vs. 71.5%, P=0.008). Multiple logistic regression analysis indicated that thrombocytopenia [odds ratio =2.260, 95% confidence interval (1.153, 4.429), P=0.018] and cardiopulmonary resuscitation duration [odds ratio=1.117, 95% confidence interval (1.060, 1.177), P<0.001] were independent risk factors for 28-day mortality in patients with in-hospital cardiac arrest. Conclusion Thrombocytopenia after restoration of spontaneous circulation is associated with poor short-term prognosis in patients with in-hospital cardiac arrest.