Prognostic value of neutrophil-lymphocyte ratio in out-of-hospital cardiac arrest patients receiving targeted temperature management: An observational cohort study
Background: Out-hospital cardiac arrest (OHCA) is a major cause of mortality and morbidity worldwide. The magnitude of the post-resuscitation inflammatory response is closely related to the severity of the circulatory dysfunction. Currently, targeted temperature management (TTM) has become an essent...
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| Format: | Article |
| Language: | English |
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Elsevier
2023-09-01
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| Series: | Journal of the Formosan Medical Association |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S0929664623000050 |
| _version_ | 1797745981852221440 |
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| author | Yung-Huai Huang Yu-Shan Lin Cheng-Hsueh Wu Chorng-Kuang How Chung-Ting Chen |
| author_facet | Yung-Huai Huang Yu-Shan Lin Cheng-Hsueh Wu Chorng-Kuang How Chung-Ting Chen |
| author_sort | Yung-Huai Huang |
| collection | DOAJ |
| description | Background: Out-hospital cardiac arrest (OHCA) is a major cause of mortality and morbidity worldwide. The magnitude of the post-resuscitation inflammatory response is closely related to the severity of the circulatory dysfunction. Currently, targeted temperature management (TTM) has become an essential part of the post-resuscitation care for unconscious OHCA survivors. Some novel prognostic inflammatory markers may help predict outcomes of OHCA patients after TTM. Methods: A retrospective observational cohort study of 65 OHCA patients treated with TTM was conducted in a tertiary hospital in Taiwan. The primary outcome measure was in-hospital mortality. Baseline and post-TTM neutrophil to lymphocyte ratio (NLR), platelet to lymphocyte (PLR), and the systemic immune inflammation index (SII) were identified as potential predictors. Results: These patients had a mean age of 62.2 ± 17.0 years. Among the total sample, 53.8% had an initial shockable rhythm and 61.5% had a presumed cardiac etiology. The median resuscitation duration was 20 min (IQR 13.5–28.5) and 60% received subsequent percutaneous coronary intervention. The mean baseline NLR, PLR and SII were 7.5 ± 16.7, 118 ± 207, 1395 ± 3004, and the mean post-TTM NLR, PLR and SII were 15.0 ± 11.6, 206 ± 124, 2369 ± 2569, respectively. Using multiple logistic regression analysis, post-TTM NLR was one of the independent factors which predicted in-hospital mortality (adjusted odds ratio (aOR): 1.249, 95% confidence interval (CI): 1.040–1.501, p = 0.017). Conclusion: Post-TTM NLR is a predictor of in-hospital mortality in OHCA patients who underwent TTM. |
| first_indexed | 2024-03-12T15:31:33Z |
| format | Article |
| id | doaj.art-7b3190651f91483f936b914a80da7f20 |
| institution | Directory Open Access Journal |
| issn | 0929-6646 |
| language | English |
| last_indexed | 2024-03-12T15:31:33Z |
| publishDate | 2023-09-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Journal of the Formosan Medical Association |
| spelling | doaj.art-7b3190651f91483f936b914a80da7f202023-08-10T04:33:45ZengElsevierJournal of the Formosan Medical Association0929-66462023-09-011229890898Prognostic value of neutrophil-lymphocyte ratio in out-of-hospital cardiac arrest patients receiving targeted temperature management: An observational cohort studyYung-Huai Huang0Yu-Shan Lin1Cheng-Hsueh Wu2Chorng-Kuang How3Chung-Ting Chen4Emergency Department, Taipei Veterans General Hospital, Taipei, TaiwanDepartment of Anesthesiology, Taipei Veterans General Hospital, Taipei, TaiwanSchool of Medicine, National Yang Ming Chiao Tung University, Taipei 112, Taiwan; Department of Critical Care Medicine, Taipei Veterans General Hospital, Taipei, TaiwanEmergency Department, Taipei Veterans General Hospital, Taipei, Taiwan; School of Medicine, National Yang Ming Chiao Tung University, Taipei 112, TaiwanEmergency Department, Taipei Veterans General Hospital, Taipei, Taiwan; School of Medicine, National Yang Ming Chiao Tung University, Taipei 112, Taiwan; Institute of Health Policy and Management, College of Public Health, National Taiwan University, Taipei, Taiwan; Corresponding author. 201, Sec. 2, Shih-Pai Rd, Taipei 112, Taiwan.Background: Out-hospital cardiac arrest (OHCA) is a major cause of mortality and morbidity worldwide. The magnitude of the post-resuscitation inflammatory response is closely related to the severity of the circulatory dysfunction. Currently, targeted temperature management (TTM) has become an essential part of the post-resuscitation care for unconscious OHCA survivors. Some novel prognostic inflammatory markers may help predict outcomes of OHCA patients after TTM. Methods: A retrospective observational cohort study of 65 OHCA patients treated with TTM was conducted in a tertiary hospital in Taiwan. The primary outcome measure was in-hospital mortality. Baseline and post-TTM neutrophil to lymphocyte ratio (NLR), platelet to lymphocyte (PLR), and the systemic immune inflammation index (SII) were identified as potential predictors. Results: These patients had a mean age of 62.2 ± 17.0 years. Among the total sample, 53.8% had an initial shockable rhythm and 61.5% had a presumed cardiac etiology. The median resuscitation duration was 20 min (IQR 13.5–28.5) and 60% received subsequent percutaneous coronary intervention. The mean baseline NLR, PLR and SII were 7.5 ± 16.7, 118 ± 207, 1395 ± 3004, and the mean post-TTM NLR, PLR and SII were 15.0 ± 11.6, 206 ± 124, 2369 ± 2569, respectively. Using multiple logistic regression analysis, post-TTM NLR was one of the independent factors which predicted in-hospital mortality (adjusted odds ratio (aOR): 1.249, 95% confidence interval (CI): 1.040–1.501, p = 0.017). Conclusion: Post-TTM NLR is a predictor of in-hospital mortality in OHCA patients who underwent TTM.http://www.sciencedirect.com/science/article/pii/S0929664623000050Cardiac arrestMortalityNeurological outcomeNeutrophil-to-lymphocyte ratioTargeted temperature managementTherapeutic hypothermia |
| spellingShingle | Yung-Huai Huang Yu-Shan Lin Cheng-Hsueh Wu Chorng-Kuang How Chung-Ting Chen Prognostic value of neutrophil-lymphocyte ratio in out-of-hospital cardiac arrest patients receiving targeted temperature management: An observational cohort study Journal of the Formosan Medical Association Cardiac arrest Mortality Neurological outcome Neutrophil-to-lymphocyte ratio Targeted temperature management Therapeutic hypothermia |
| title | Prognostic value of neutrophil-lymphocyte ratio in out-of-hospital cardiac arrest patients receiving targeted temperature management: An observational cohort study |
| title_full | Prognostic value of neutrophil-lymphocyte ratio in out-of-hospital cardiac arrest patients receiving targeted temperature management: An observational cohort study |
| title_fullStr | Prognostic value of neutrophil-lymphocyte ratio in out-of-hospital cardiac arrest patients receiving targeted temperature management: An observational cohort study |
| title_full_unstemmed | Prognostic value of neutrophil-lymphocyte ratio in out-of-hospital cardiac arrest patients receiving targeted temperature management: An observational cohort study |
| title_short | Prognostic value of neutrophil-lymphocyte ratio in out-of-hospital cardiac arrest patients receiving targeted temperature management: An observational cohort study |
| title_sort | prognostic value of neutrophil lymphocyte ratio in out of hospital cardiac arrest patients receiving targeted temperature management an observational cohort study |
| topic | Cardiac arrest Mortality Neurological outcome Neutrophil-to-lymphocyte ratio Targeted temperature management Therapeutic hypothermia |
| url | http://www.sciencedirect.com/science/article/pii/S0929664623000050 |
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