The following is a summary of “Prognostic value of the phosphate-to-albumin ratio in patients with OHCA: A multicenter observational study,” published in the April 2024 issue of Emergency Medicine by Yoo, et al.

For a study, researchers sought to validate the prognostic utility of the phosphate-to-albumin ratio (PAR) in predicting neurological outcomes and in-hospital mortality among patients with return of spontaneous circulation (ROSC) following out-of-hospital cardiac arrest (OHCA). The PAR incorporates albumin, an additional prognostic indicator, alongside phosphate levels previously associated with unfavorable outcomes.

A multicenter observational study was conducted involving adult OHCA survivors from October 2015 to June 2021. The primary endpoint was the unfavorable neurological outcome at hospital discharge, defined as a cerebral performance category score of 3–5. Additionally, in-hospital mortality rates were assessed.

Among 2,397 adult OHCA survivors, PAR exhibited significant differences between unfavorable and favorable neurological outcome groups, as well as between non-survivors and survivors of hospital discharge (2.4 vs. 1.4, 2.5 vs. 1.6, respectively). The area under the receiver operating characteristic curve (AUROC) value of PAR for predicting unfavorable neurological outcomes was 0.81 (95% CI, 0.79–0.83), and for predicting in-hospital mortality was 0.76 (95% CI, 0.74–0.78). In multivariable analysis, PAR independently correlated with unfavorable neurological outcome (odds ratio [OR] 1.30, 95% CI 1.15–1.37; P < 0.001) and in-hospital mortality (OR 1.24, 95% CI 1.12–1.38; P < 0.001).

The PAR emerged as a readily accessible and independent prognostic indicator for OHCA survivors with ROSC, aiding healthcare providers in predicting outcomes and informing treatment decisions.

Reference: sciencedirect.com/science/article/abs/pii/S0735675723006927