Prognostic Significance of Initial Serum Albumin on Mortality in Out-of-hospital Cardiac Arrest
Journal of the Korean Society of Emergency Medicine
; : 500-507, 2013.
Article
in English
| WPRIM (Western Pacific)
| ID: wpr-138355
Responsible library:
WPRO
ABSTRACT
PURPOSE:
The association of serum albumin concentration on hospital arrival with long-term mortality in survivors from out-of-hospital cardiac arrest (OHCA) was investigated.METHODS:
A retrospective analysis was conducted of patients presumed to have cardiac cause of arrest and achieved sustained return of spontaneous circulation (ROSC) from prospective OHCA. The individual medical records were reviewed for data, including initial serum albumin. The primary outcome was survival at 6 months and the secondary outcome was Cerebral Performance Category (CPC) at 6 months. Differences in variables between survivors and non-survivors at 6 months after cardiac arrest were analyzed. Albumin was categorized into tertiles of 3.7 g/dL. Hazard ratios (HRs) were estimated using Cox-proportional hazard models in both univariate and multivariate analysis. All prognostic variables with p value<0.1 in univariate analysis were used in multivariate analysis for adjustment. Receiver operating curve (ROC) analysis was performed to evaluate the discriminative power of albumin.RESULTS:
In a total of 547 OHCA patients, 136 patients had a presumed cardiac cause of arrest and sustained ROSC with available initial serum albumin. The survival rate at 6 months was significantly higher in patients in the higher albumin group and neurological outcomes were also more favorable in the higher albumin group (log rank test, p<0.05). In a Cox proportional hazard regression analysis, initial serum lactate and albumin levels were independently associated with 6-month mortality and albumin levels showed moderate discriminative power for 6-month mortality by ROC analysis (AUC=0.738, 95% CI 0.652-0.825).CONCLUSION:
Serum albumin is associated with long-term mortality and neurological outcome in patients with presumed cardiac cause of arrest and sustained ROSC from OHCA.
Full text:
Available
Health context:
SDG3 - Target 3.4 Reduce premature mortality due to noncommunicable diseases
Health problem:
Cardiovascular Disease
Database:
WPRIM (Western Pacific)
Main subject:
Prognosis
/
Serum Albumin
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Proportional Hazards Models
/
Medical Records
/
Multivariate Analysis
/
Survival Rate
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Prospective Studies
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Retrospective Studies
/
ROC Curve
/
Mortality
Type of study:
Observational study
/
Prognostic study
Limits:
Humans
Language:
English
Journal:
Journal of the Korean Society of Emergency Medicine
Year:
2013
Document type:
Article