Blood laboratory analyses preceding in-hospital cardiac arrest: A matched case-control study.

IF 1.9 4区医学 Q2 ANESTHESIOLOGY Acta Anaesthesiologica Scandinavica Pub Date : 2024-09-01 Epub Date: 2024-05-23 DOI:10.1111/aas.14454

Peter C Lind, Nikola Stankovic, Mathias J Holmberg, Lars W Andersen, Asger Granfeldt

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Abstract

Background: Whether blood laboratory analyses differ in patients who later suffer in-hospital cardiac arrest (IHCA) compared to other hospitalised patients remains unknown. The aim of this study was to describe pre-arrest sampling frequencies, results, and trends in blood laboratory analyses in patients with IHCA compared to controls.

Methods: This study was a matched case-control study using national registries in Denmark. Cases were defined as patients with IHCA from 2017 to 2021. Controls were defined as hospitalised patients and were matched on age, sex, and date and length of admission. Data on a total of 51 different blood laboratory analyses were obtained. The laboratory analyses of primary interest were lactate, sodium, potassium, and haemoglobin. The index time for cases was defined as the time of cardiac arrest, and a corresponding index time was defined for controls based on the time to cardiac arrest for their corresponding case. Blood sampling frequencies were reported for blood laboratory analyses obtained either within the last 24 h before the index time or between the time of hospital admission and the index time. Blood sampling results were reported for blood laboratory analyses obtained within the last 24 h before the index time.

Results: A total of 9268 cases and 92,395 controls were included in this study. Cases underwent more frequent sampling of all blood laboratory analyses compared to controls. This higher sampling frequency was more pronounced for lactate compared to sodium, potassium, or haemoglobin. The last measured lactate was higher in cases (median [IQR]: 2.3 [1.3, 4.9]) compared to controls (median [IQR]: 1.3 [0.9, 2.0]). Differences in sodium, potassium, and haemoglobin were negligible. The proportion of abnormally elevated levels of lactate and potassium increased as time to cardiac arrest decreased; no such effect was seen in controls. No temporal trend was evident for sodium or haemoglobin.

Conclusions: Patients with IHCA undergo more frequent blood sampling prior to IHCA and have higher levels of lactate compared to matched controls.

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院内心脏骤停前的血液化验分析：匹配病例对照研究。

背景：与其他住院患者相比，院内心脏骤停（IHCA）患者的血液化验分析是否存在差异仍是未知数。本研究旨在描述与对照组相比，院内心脏骤停患者骤停前血液实验室分析的采样频率、结果和趋势：本研究是一项配对病例对照研究，使用的是丹麦的国家登记资料。病例定义为2017年至2021年的IHCA患者。对照组定义为住院患者，并在年龄、性别、入院日期和住院时间上进行匹配。共获得了 51 项不同的血液实验室分析数据。主要关注的实验室分析包括乳酸盐、钠、钾和血红蛋白。病例的指数时间定义为心脏骤停的时间，对照组的相应指数时间则根据其相应病例的心脏骤停时间来定义。对于指数时间前 24 小时内或入院时间与指数时间之间的血液化验分析，均报告了血液采样频率。报告了指数时间前 24 小时内的血液化验结果：本研究共纳入 9268 例病例和 92395 例对照。与对照组相比，病例接受所有血液化验分析采样的频率更高。与钠、钾或血红蛋白相比，乳酸盐的采样频率更高。与对照组（中位数[IQR]：1.3 [0.9，2.0]）相比，病例最后一次测量的乳酸更高（中位数[IQR]：2.3 [1.3，4.9]）。钠、钾和血红蛋白的差异可以忽略不计。随着心脏骤停时间的缩短，乳酸和血钾水平异常升高的比例也在增加；而对照组中没有出现这种情况。钠和血红蛋白没有明显的时间趋势：结论：与匹配的对照组相比，IHCA 患者在 IHCA 前更频繁地抽血，乳酸水平更高。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Acta Anaesthesiologica Scandinavica 医学-麻醉学

CiteScore

4.30

自引率

9.50%

发文量

157

审稿时长

3-8 weeks

期刊介绍： Acta Anaesthesiologica Scandinavica publishes papers on original work in the fields of anaesthesiology, intensive care, pain, emergency medicine, and subjects related to their basic sciences, on condition that they are contributed exclusively to this Journal. Case reports and short communications may be considered for publication if of particular interest; also letters to the Editor, especially if related to already published material. The editorial board is free to discuss the publication of reviews on current topics, the choice of which, however, is the prerogative of the board. Every effort will be made by the Editors and selected experts to expedite a critical review of manuscripts in order to ensure rapid publication of papers of a high scientific standard.