Early prediction cardiac arrest in intensive care units: the value of laboratory indicator trends

The incidence of in-hospital cardiac arrest (IHCA) has increased over the past decade, with more than half occurring in intensive care units (ICUs). [1]ICU cardiac arrest (ICU-CA) presents unique challenges, with worse outcomes than those in monitored wards, highlighting the need for early detection and intervention. [2]Up to 80% of patients exhibit signs of deterioration hours before IHCA. [3]Although early warning scores based on vital signs are useful, their eff ectiveness in ICUs is limited due to abnormal physiological parameters. [4]aboratory markers, such as sodium, potassium, and lactate, are predictive of poor outcomes, [5] but static measurements may not capture the patient's trajectory.Trends in laboratory indicators, such as variability and extremes, may off er better predictive value. [6]This study aimed to evaluate ICU-CA predictive factors, with a focus on vital signs and trends of laboratory indicators.We conducted a retrospective matched case-control study from December 1st, 2016, to November 31st, 2019, in six ICUs of Qilu Hospital of Shandong University.Patients aged >14 years who experienced ICU-CA, defined as circulatory arrest receiving cardiopulmonary resuscitation (CPR), including chest compressions and/or cardiac defi brillation, were included.The exclusion criteria were donot-attempt resuscitation orders, cardiac arrest (CA) before ICU admission, ICU stays <48 h, or intraoperative CA.Controls were patients without CA events during their ICU stays and were selected at a 1:2 ratio after being matched to CA cases by ICU, sex, admitting diagnosis, and admission