Neutrophil-Lymphocyte Ratio as a Mortality Predictive Paramater In Patıents Wıth Out-of-Hospital Cardiac Arrest

Abstract

Introduction:The rates of out-of-hospital cardiac arrest (OHCA) are increasing day by day in a progressive manner. Despite all the improvements in care after cardiac arrest, the majority of fatalities occur in the first 24-hours following the cardiac arrest.In recent years, the ratio of the peripheral neutrophils to lymphocytes (NLR) has been accepted as a prognostic marker in many diseases. We also aimed to investigate the correlation of the NLR with mortality in patients with OHCA.Methods:The study design was planned by retrospective scanning of all OHCA patients with return of spontaneous circulation(ROSC). The demographic features and laboratory data were recorded. The survival rates for the 24-hours and 14-days were calculated.Results: 91 patients were included out of 191 cases who had returned from OHCA to spontaneous circulation. When the patients who had died and survived in the first 24-hours were compared, significant differences were found between the neutrophil counts, NLR, lactate and arrest rhythms on admission (p<0.05). The survival rates calculated by Kaplan Meier curves were significantly lower in the group with NLR values lower than 3.05 (Log Rank 5.07, p=0.02). With the multivariable Cox-regression model, it was determined that the NLR value being lower than 3.05, is a predictive factor for the 24-hour mortality independent of age, gender, blood lactate and creatinine values and the arrest rhythm on admission (Hazard Ratio: 0.34 (0.15-0.79), p=0.01).Conclusion: Among the OHCA patients with ROSC, low NLR levels on admission is an independent predictor of mortality in the first 24-hours.

Keywords

• emregency
• NLR
• resuscitation

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