1 | INTRODUCTION
Cardiopulmonary resuscitation (CPR) is the most important interventional procedure which contributes to the survival of patients with cardiac arrest (CA) and consists of basic and advanced life supports.1 Despite major advances in CPR and post-resuscitation care, patients surviving out of hospital cardiac arrest (OHCA) still carry poor prognosis including increased risk of mortality and morbidity.2,3 The whole-body ischemia during CA leads to systemic inflammatory response damage and reperfusion of this tissue triggers even more tissue injury which is defined as ischemia-reperfusion injury.4 Therefore, it is important to evaluate the prognosis after CPR in patients who survived from CA.
Systemic inflammation can be evaluated with many laboratory markers. One of these markers is neutrophil to lymphocyte ratio (NLR) which reflect the balance between neutrophils and lymphocytes.5 NLR play a crucial role in the ischemia-reperfusion injury. It has been demonstrated that higher NLR is associated with mortality in patients with OHCA.6 Nevertheless, C-reactive protein (CRP) to albumin ratio (CAR) is also a novel marker of systemic inflammation. It reflects the balance between CRP and albumin and detected to be more sensitive than CRP and albumin separately to evaluate the intense of inflammatory response.7 The clinical importance of CAR has been demonstrated in different patient population.8-10
Although previous studies investigated the association of NLR with prognosis in patients with OHCA, to our knowledge, there is no study evaluating the clinical importance of CAR in these patients. The aim of our study is to assess the effect of CAR on mortality in patients with OHCA.