Association between humoral immunity and clinical outcomes of patients after out-of-hospital cardiac arrest and resuscitation: a retrospective study
Abstract Background Patients with out-of-hospital cardiac arrest (OHCA) suffer from hypoxia-ischemia and ischemia-reperfusion injury (IRI) after the return of spontaneous circulation (ROSC). The impact of early humoral immunity on prognosis in this process remains unclear. Methods Outcomes at discha...
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BMC
2025-07-01
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| Series: | BMC Emergency Medicine |
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| Online Access: | https://doi.org/10.1186/s12873-025-01282-0 |
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| author | Zhenyu Shan Xingsheng Wang Le An Chenchen Hang Zihao Jiang Weijie Cheng Ziqi Zhong Rui Shao Ziren Tang |
| author_facet | Zhenyu Shan Xingsheng Wang Le An Chenchen Hang Zihao Jiang Weijie Cheng Ziqi Zhong Rui Shao Ziren Tang |
| author_sort | Zhenyu Shan |
| collection | DOAJ |
| description | Abstract Background Patients with out-of-hospital cardiac arrest (OHCA) suffer from hypoxia-ischemia and ischemia-reperfusion injury (IRI) after the return of spontaneous circulation (ROSC). The impact of early humoral immunity on prognosis in this process remains unclear. Methods Outcomes at discharge were evaluated in 183 patients resuscitated from OHCA, including neurological outcomes as measured by CPC scores, survival, and length of stay (LOS). Humoral immunity, including IgG, IgA, IgM, C3, and C4, was tested on the first day of admission. Difference test, restricted cubic spline, and correlation analysis were used to analyze the correlation between humoral immunity and outcomes. Results Differences were observed in IgM, C3, and C4 levels among patients with different prognoses. Patients with poor prognosis have lower IgM levels (CPC 1–2 vs. CPC 3–5: 68.3[47.05–105] vs. 55.45[31.95–86.12] mg/dL, P = 0.0256), lower C3 levels (CPC 1–2 vs. CPC 3–5: 72.1[62.6–72.1] vs. 63.05[49.83–79.72] mg/dL, P = 0.0091; survival vs. dead: 72.1[60.9-86.62] vs. 58.7[43.7–72.6] mg/dL, P < 0.0001), and lower C4 levels (survival vs. dead: 18.9[15.38–22.92] vs. 17.2[11.85–21.5] mg/dL, P = 0.0148). Non-linear correlations were found between humoral immunity and prognosis (IgM: ORnon−linear=1.068[95%CI: 1.009–1.130], Pnon−linear=0.0236); C3: ORnon−linear=1.048[95%CI: 1.000-1.097], Pnon−linear=0.0488). LOS was negatively linearly correlated with IgG (R2 adjusted = 0.115, P = 0.0148) and C3 (R2 adjusted = 0.127, P = 0.0108) in patients with CPC 1–2. Conclusions Humoral immunity is at a low level in OHCA patients after ROSC, and humoral immunity was associated with neurological prognosis, survival at discharge, and LOS. |
| format | Article |
| id | doaj-art-b27e1802afa24f2f87e7564aa8a42ca6 |
| institution | DOAJ |
| issn | 1471-227X |
| language | English |
| publishDate | 2025-07-01 |
| publisher | BMC |
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| series | BMC Emergency Medicine |
| spelling | doaj-art-b27e1802afa24f2f87e7564aa8a42ca62025-08-20T03:04:26ZengBMCBMC Emergency Medicine1471-227X2025-07-0125111110.1186/s12873-025-01282-0Association between humoral immunity and clinical outcomes of patients after out-of-hospital cardiac arrest and resuscitation: a retrospective studyZhenyu Shan0Xingsheng Wang1Le An2Chenchen Hang3Zihao Jiang4Weijie Cheng5Ziqi Zhong6Rui Shao7Ziren Tang8Department of Emergency Medicine, Beijing Chaoyang Hospital, Capital Medical UniversityDepartment of Emergency Medicine, Beijing Chaoyang Hospital, Capital Medical UniversityDepartment of Emergency Medicine, Beijing Chaoyang Hospital, Capital Medical UniversityDepartment of Emergency Medicine, Beijing Chaoyang Hospital, Capital Medical UniversityDepartment of Emergency Medicine, Beijing Chaoyang Hospital, Capital Medical UniversityDepartment of Emergency Medicine, Beijing Chaoyang Hospital, Capital Medical UniversityDepartment of Emergency Medicine, Beijing Chaoyang Hospital, Capital Medical UniversityDepartment of Emergency Medicine, Beijing Chaoyang Hospital, Capital Medical UniversityDepartment of Emergency Medicine, Beijing Chaoyang Hospital, Capital Medical UniversityAbstract Background Patients with out-of-hospital cardiac arrest (OHCA) suffer from hypoxia-ischemia and ischemia-reperfusion injury (IRI) after the return of spontaneous circulation (ROSC). The impact of early humoral immunity on prognosis in this process remains unclear. Methods Outcomes at discharge were evaluated in 183 patients resuscitated from OHCA, including neurological outcomes as measured by CPC scores, survival, and length of stay (LOS). Humoral immunity, including IgG, IgA, IgM, C3, and C4, was tested on the first day of admission. Difference test, restricted cubic spline, and correlation analysis were used to analyze the correlation between humoral immunity and outcomes. Results Differences were observed in IgM, C3, and C4 levels among patients with different prognoses. Patients with poor prognosis have lower IgM levels (CPC 1–2 vs. CPC 3–5: 68.3[47.05–105] vs. 55.45[31.95–86.12] mg/dL, P = 0.0256), lower C3 levels (CPC 1–2 vs. CPC 3–5: 72.1[62.6–72.1] vs. 63.05[49.83–79.72] mg/dL, P = 0.0091; survival vs. dead: 72.1[60.9-86.62] vs. 58.7[43.7–72.6] mg/dL, P < 0.0001), and lower C4 levels (survival vs. dead: 18.9[15.38–22.92] vs. 17.2[11.85–21.5] mg/dL, P = 0.0148). Non-linear correlations were found between humoral immunity and prognosis (IgM: ORnon−linear=1.068[95%CI: 1.009–1.130], Pnon−linear=0.0236); C3: ORnon−linear=1.048[95%CI: 1.000-1.097], Pnon−linear=0.0488). LOS was negatively linearly correlated with IgG (R2 adjusted = 0.115, P = 0.0148) and C3 (R2 adjusted = 0.127, P = 0.0108) in patients with CPC 1–2. Conclusions Humoral immunity is at a low level in OHCA patients after ROSC, and humoral immunity was associated with neurological prognosis, survival at discharge, and LOS.https://doi.org/10.1186/s12873-025-01282-0Out-of-hospital cardiac arrestReturn of spontaneous circulationHumoral immunityOutcome |
| spellingShingle | Zhenyu Shan Xingsheng Wang Le An Chenchen Hang Zihao Jiang Weijie Cheng Ziqi Zhong Rui Shao Ziren Tang Association between humoral immunity and clinical outcomes of patients after out-of-hospital cardiac arrest and resuscitation: a retrospective study BMC Emergency Medicine Out-of-hospital cardiac arrest Return of spontaneous circulation Humoral immunity Outcome |
| title | Association between humoral immunity and clinical outcomes of patients after out-of-hospital cardiac arrest and resuscitation: a retrospective study |
| title_full | Association between humoral immunity and clinical outcomes of patients after out-of-hospital cardiac arrest and resuscitation: a retrospective study |
| title_fullStr | Association between humoral immunity and clinical outcomes of patients after out-of-hospital cardiac arrest and resuscitation: a retrospective study |
| title_full_unstemmed | Association between humoral immunity and clinical outcomes of patients after out-of-hospital cardiac arrest and resuscitation: a retrospective study |
| title_short | Association between humoral immunity and clinical outcomes of patients after out-of-hospital cardiac arrest and resuscitation: a retrospective study |
| title_sort | association between humoral immunity and clinical outcomes of patients after out of hospital cardiac arrest and resuscitation a retrospective study |
| topic | Out-of-hospital cardiac arrest Return of spontaneous circulation Humoral immunity Outcome |
| url | https://doi.org/10.1186/s12873-025-01282-0 |
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