Association between fibrinogen levels and mortality following cardiopulmonary resuscitation: a retrospective cohort study

Background: Cardiac arrest (CA) is a critical condition that would cause high mortality. Fibrinogen, as a macromolecular protein involved in both inflammatory response and coagulation regulation, was reported to be associated with a series of life-threatening conditions. The aim of this study is to...

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Main Authors: Xin Cheng, Ran Chen, Xiaowen Zhang, Gongpeng Zhang, Haiyan Ju, Guangyuan Zhang, Wengang Liu, Jie Sun
Format: Article
Language:English
Published: Elsevier 2025-09-01
Series:Resuscitation Plus
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Online Access:http://www.sciencedirect.com/science/article/pii/S2666520425001778
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author Xin Cheng
Ran Chen
Xiaowen Zhang
Gongpeng Zhang
Haiyan Ju
Guangyuan Zhang
Wengang Liu
Jie Sun
author_facet Xin Cheng
Ran Chen
Xiaowen Zhang
Gongpeng Zhang
Haiyan Ju
Guangyuan Zhang
Wengang Liu
Jie Sun
author_sort Xin Cheng
collection DOAJ
description Background: Cardiac arrest (CA) is a critical condition that would cause high mortality. Fibrinogen, as a macromolecular protein involved in both inflammatory response and coagulation regulation, was reported to be associated with a series of life-threatening conditions. The aim of this study is to investigate the association between fibrinogen level and prognosis of patients after cardiac arrest. Methods: This study is a retrospective study utilizing the database MIMIC-IV version 1.0. Logistic regression and Cox proportional hazards regression were applied to explore the relationship between fibrinogen and in-hospital, 30-day, 90-day mortality of patients after cardiac arrest. Kaplan-Meier survival curve was also drawn. Subgroup analysis was conducted to explore whether the association remains in various subgroups. In addition, propensity score matching (PSM) was used to adjust confounding factor. Results: 525 eligible patients were enrolled in total. Among them, 238 patients survived and 287 died during ICU hospitalization. Kaplan-Meier curve showed significant difference in survival probability (p < 0.01). For in-hospital mortality, reduced fibrinogen level was considered as a risk factor regardless of univariate regression (OR = 1.67, 95 % CI [1.08, 2.58], p = 0.022) or multivariate regression (OR = 1.26, 95 % CI [1.09, 1.43], p = 0.031). For 30-day mortality and 90-day mortality, reduced fibrinogen level was still a significant risk factor. Furthermore, such an association was demonstrated by subgroup analysis and propensity score matching. Conclusion: The presence of reduced fibrinogen level indicates a heightened risk of mortality in patients after cardiac arrest, whereas elevated fibrinogen level may be not associated with mortality.
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spelling doaj-art-0298ab00d73e4f41b90c4e15a8b586df2025-08-20T03:44:25ZengElsevierResuscitation Plus2666-52042025-09-012510104010.1016/j.resplu.2025.101040Association between fibrinogen levels and mortality following cardiopulmonary resuscitation: a retrospective cohort studyXin Cheng0Ran Chen1Xiaowen Zhang2Gongpeng Zhang3Haiyan Ju4Guangyuan Zhang5Wengang Liu6Jie Sun7Department of General Surgery, Ya’an Polytechnic College Affiliated Hospital, Ya’an 625000, ChinaDepartment of Urology, Zhongda Hospital, Southeast University, Nanjing 210009, China; School of Medicine, Southeast University, Nanjing 210009, ChinaDepartment of Urology, Zhongda Hospital, Southeast University, Nanjing 210009, ChinaDepartment of Urology, Zhongda Hospital, Southeast University, Nanjing 210009, ChinaDepartment of Urology, Zhongda Hospital, Southeast University, Nanjing 210009, ChinaDepartment of Urology, Zhongda Hospital, Southeast University, Nanjing 210009, China; Corresponding authors.Department of Urology, People’s Hospital of Chenghai, Shantou 515899, China; Corresponding authors.Department of Urology, Shanghai Children’s Medical Center, Shanghai Jiao Tong University School of Medicine, Shanghai 200127, China; Corresponding authors.Background: Cardiac arrest (CA) is a critical condition that would cause high mortality. Fibrinogen, as a macromolecular protein involved in both inflammatory response and coagulation regulation, was reported to be associated with a series of life-threatening conditions. The aim of this study is to investigate the association between fibrinogen level and prognosis of patients after cardiac arrest. Methods: This study is a retrospective study utilizing the database MIMIC-IV version 1.0. Logistic regression and Cox proportional hazards regression were applied to explore the relationship between fibrinogen and in-hospital, 30-day, 90-day mortality of patients after cardiac arrest. Kaplan-Meier survival curve was also drawn. Subgroup analysis was conducted to explore whether the association remains in various subgroups. In addition, propensity score matching (PSM) was used to adjust confounding factor. Results: 525 eligible patients were enrolled in total. Among them, 238 patients survived and 287 died during ICU hospitalization. Kaplan-Meier curve showed significant difference in survival probability (p < 0.01). For in-hospital mortality, reduced fibrinogen level was considered as a risk factor regardless of univariate regression (OR = 1.67, 95 % CI [1.08, 2.58], p = 0.022) or multivariate regression (OR = 1.26, 95 % CI [1.09, 1.43], p = 0.031). For 30-day mortality and 90-day mortality, reduced fibrinogen level was still a significant risk factor. Furthermore, such an association was demonstrated by subgroup analysis and propensity score matching. Conclusion: The presence of reduced fibrinogen level indicates a heightened risk of mortality in patients after cardiac arrest, whereas elevated fibrinogen level may be not associated with mortality.http://www.sciencedirect.com/science/article/pii/S2666520425001778FibrinogenCardiac arrestResuscitationMortalityMIMIC IV
spellingShingle Xin Cheng
Ran Chen
Xiaowen Zhang
Gongpeng Zhang
Haiyan Ju
Guangyuan Zhang
Wengang Liu
Jie Sun
Association between fibrinogen levels and mortality following cardiopulmonary resuscitation: a retrospective cohort study
Resuscitation Plus
Fibrinogen
Cardiac arrest
Resuscitation
Mortality
MIMIC IV
title Association between fibrinogen levels and mortality following cardiopulmonary resuscitation: a retrospective cohort study
title_full Association between fibrinogen levels and mortality following cardiopulmonary resuscitation: a retrospective cohort study
title_fullStr Association between fibrinogen levels and mortality following cardiopulmonary resuscitation: a retrospective cohort study
title_full_unstemmed Association between fibrinogen levels and mortality following cardiopulmonary resuscitation: a retrospective cohort study
title_short Association between fibrinogen levels and mortality following cardiopulmonary resuscitation: a retrospective cohort study
title_sort association between fibrinogen levels and mortality following cardiopulmonary resuscitation a retrospective cohort study
topic Fibrinogen
Cardiac arrest
Resuscitation
Mortality
MIMIC IV
url http://www.sciencedirect.com/science/article/pii/S2666520425001778
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