Evaluation of the factors affecting mortality after cardiac arrest - do lactate and procalcitonin concentrations have...

Area of Science:

• Critical Care Medicine
• Cardiology
• Biochemistry

Background:

• Patients admitted to the Intensive Care Unit (ICU) following cardiac arrest face high mortality and morbidity.
• Accurate prognostication is crucial for effective patient management and resource allocation.

Purpose of the Study:

• To determine mortality rates in post-cardiac arrest ICU patients.
• To identify risk factors and predictive factors for mortality in this patient population.

Main Methods:

• Retrospective review of 151 adult patient files admitted to ICU post-cardiac arrest (January 2017 - June 2020).
• Data collected included demographics, comorbidities, arrest details, APACHE 2 scores, blood gases (pH, HCO3), lactate levels (hourly), procalcitonin (PRC), and blood glucose.
• Patients were analyzed in survivor and non-survivor groups.

Main Results:

• Non-survivors exhibited lower pH and HCO3 levels compared to survivors.
• While initial procalcitonin (PRC) levels were similar, 24-hour PRC levels and changes were higher in non-survivors.
• Elevated 24-hour lactate levels and greater changes in lactate over 24 hours were significant predictors of mortality, identified via ROC curve and logistic regression.

Conclusions:

• Lactate levels and their changes are independent risk factors for mortality in post-cardiac arrest ICU patients.
• Integrating lactate dynamics with procalcitonin (PRC) and clinical findings can enhance prognostic accuracy.
• Early identification of high-risk patients through these markers can guide treatment strategies.