Abstract
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.