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Original Research

Open Access Special Issue

Prognostic value of serum phosphate level in elderly post-cardiac arrest patients

  • Hee Eun Kim1
  • Young Taeck Oh2,*,†,
  • You Hwan Jo1,3
  • Jonghwan Shin3,4
  • Seung Min Park1,3,*,†,
  • Dong Keon Lee1,3
  • Yoon Sun Jung5
  • Dong-Hyun Jang6
  • on behalf of the SNU CARE Investigators

1Department of Emergency Medicine, Seoul National University Bundang Hospital, 13620 Seongnam-si, Republic of Korea

2Department of Emergency Medicine, Hallym University Dongtan Sacred Heart Hospital, 18450 Hwaseong, Republic of Korea

3Department of Emergency Medicine, Seoul National University College of Medicine, 03080 Seoul, Republic of Korea

4Department of Emergency Medicine, Seoul Metropolitan Government—Seoul National University Boramae Medical Center, 07061 Seoul, Republic of Korea

5Division of Critical Care Medicine, Seoul National University Hospital, 03080 Seoul, Republic of Korea

6Department of Emergency Medicine, Uijeongbu Eulji Medical Center, Eulji University, 11759 Uijeongbu, Republic of Korea

DOI: 10.22514/sv.2022.047

Submitted: 17 February 2022 Accepted: 07 May 2022

Online publish date: 06 July 2022

*Corresponding Author(s): Young Taeck Oh E-mail:
*Corresponding Author(s): Seung Min Park E-mail:

† These authors contributed equally.


Prognosticating the neurological outcomes of cardiac arrest is important. A recent study has shown that serum phosphate (SP) may be a prognostic indicator for poor neurological outcomes in cardiac arrest patients. Due to advancements in medicine, more elderly patients survive cardiac arrest than ever before, and prognostication of the markers in this population has not been studied previously. We aimed to confirm the hypothesis that a higher SP level predicts a poor neurological outcome of cardiac arrest, even in elderly patients. This retrospective observational study included post-cardiac arrest elderly patients (aged ≥ 65 years) who were admitted to three hospitals in urban areas in South Korea from December 2013 to February 2020. Data regarding patient characteristics, laboratory values, and neurological outcomes at 28 days were collected from patients’ medical records. The primary outcome was poor neurological outcome (Cerebral Performance Category scores 3–5) at 28 days. Of the 389 eligible patients, 334/389 had poor neurological outcomes at 28 days. SP levels were significantly higher in those with poor neurological outcomes than in those with good neurological outcomes (7.32 vs. 5.01, p < 0.001). Multivariate logistic regression analysis also showed that SP levels were independently associated with neurological outcomes. Receiver operating characteristic curve analysis of SP levels showed an area under the curve of 0.772. Higher SP levels are associated with poor neurological outcomes after cardiac arrest in the elderly population.


Heart arrest; Prognosis; Phosphates; Aged

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Hee Eun Kim,Young Taeck Oh,You Hwan Jo,Jonghwan Shin,Seung Min Park,Dong Keon Lee,Yoon Sun Jung,Dong-Hyun Jang,on behalf of the SNU CARE Investigators. Prognostic value of serum phosphate level in elderly post-cardiac arrest patients. Signa Vitae. 2022.doi:10.22514/sv.2022.047.


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