Prognostic value of glucose-to-potassium ratio and other biomarkers in in-hospital cardiac arrest

Background: This study aimed to evaluate the prognostic value of the serum glucose/potassium ratio (GPR) for sustained return of spontaneous circulation (ROSC) and 30-day mortality in patients with in-hospital cardiac arrest (IHCA). Methods: Patients aged 18 years or older who underwent cardiopulmonary resuscitation (CPR) for cardiac arrest in the emergency department (ED) were included. Routine laboratory parameters were obtained from the first blood sample collected during CPR in the ED. The neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR) were calculated by dividing the absolute number of neutrophils and platelets, respectively, by the absolute number of lymphocytes. The GPR was calculated as serum glucose divided by potassium levels. Results: The 30-day mortality rate was 82.2% (n = 291). Multivariate logistic regression analysis identified lactate, NLR, PLR and GPR as independent predictors of mortality. Among these markers, lactate exhibited the highest predictive power for mortality, with an area under the curve (AUC) of 0.817, compared to NLR (AUC: 0.676), PLR (AUC: 0.679) and GPR (AUC: 0.688). The optimal cut-off values for predicting mortality were 7.83 for lactate (sensitivity: 75.3%, specificity: 89.4%), 1.68 for NLR (sensitivity: 78.8%, specificity: 71.7%), 199.26 for PLR (sensitivity: 76.4%, specificity: 92.3%) and 57.81 for GPR (sensitivity: 71.8%, specificity: 84.1%). Conclusions: Our findings suggest that GPR is a promising prognostic marker for predicting mortality in patients with IHCA.

In-hospital cardiac arrest; Mortality; Glucose/potassium ratio; Emergency department

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