Research Article: The association between the sodium-potassium ratio and ICU mortality in cardiac arrest patients: an analysis of the eICU database
Abstract:
Electrolyte imbalance, particularly abnormalities in potassium and sodium homeostasis, represents an important and potentially modifiable risk factor for in-hospital cardiac arrest. Severe disturbances in potassium or sodium levels can precipitate fatal arrhythmias and are associated with poor outcomes following resuscitation. Timely correction of these electrolyte disorders may therefore reduce mortality in patients with cardiac arrest. Although the urine sodium-potassium (Na + /K + ) ratio has been shown to be associated with prognosis in various cardiovascular diseases, the prognostic value of the serum Na + /K + ratio in predicting intensive care unit (ICU) mortality among patients with cardiac arrest remains incompletely understood. This study aims to investigate the association between the serum Na + /K + ratio in patients following cardiac arrest and the risk of ICU mortality.
We screened 4,085 ICU-admitted cardiac arrest patients from the eICU-CRD databases, stratified by Na + /K + ratio tertiles. Endpoints was ICU mortality. Analyses used logistic regression, restricted cubic splines, and subgroup analyses.
A total of 4,085 patients met the inclusion criteria, including 2,392 males, with a mean age of 63.7 years. A U-shaped association was observed between the Na + /K + ratio and ICU mortality. In the fully adjusted model, a higher Na + /K + ratio was significantly associated with reduced ICU mortality (adjusted OR = 0.75; 95% CI: 0.64–0.89). The prognostic value of the Na + /K + ratio for ICU mortality remained consistent across all subgroups, with no significant interactions observed.
To summarize, we identified a marked U-shaped relationship between the serum Na + /K + ratio and ICU mortality among cardiac arrest patients. Routine assessment of this metric could facilitate risk stratification and inform clinical management.
Introduction:
Electrolyte imbalance, particularly abnormalities in potassium and sodium homeostasis, represents an important and potentially modifiable risk factor for in-hospital cardiac arrest. Severe disturbances in potassium or sodium levels can precipitate fatal arrhythmias and are associated with poor outcomes following resuscitation. Timely correction of these electrolyte disorders may therefore reduce mortality in patients with cardiac arrest. Although the urine sodium-potassium (Na + /K + ) ratio has been shown to be…
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