Association between blood pressure response index and in-hospital outcomes in cardiac arrest patients: A retrospective study

Cardiac arrest (CA) remains one of the leading causes of mortality in intensive care units. Most patients with CA receive vasoactive drugs; however, the relationship between cardiovascular responsiveness to these agents during post-resuscitation care and clinical outcomes is not fully understood. We evaluated the association between the blood pressure response index (BPRI), defined as the ratio of mean arterial pressure to the vasoactive inotropic score, and adverse in-hospital outcomes in patients with CA. In this retrospective cohort study, we analyzed 109 adult patients with CA treated in the emergency intensive care unit of the Second People's Hospital of Hefei between January 2019 and March 2024. Among the 109 patients, 41 survived to hospital discharge and 68 died. Non-survivors had significantly higher sequential organ failure assessment scores and acute physiology score, as well as higher white blood cell counts and lactate levels. In multivariable logistic regression analyses, lower BPRI values were independently associated with increased risks of in-hospital mortality (odds ratio, 5.35; 95% confidence interval, 1.29-22.17) and acute kidney injury (odds ratio, 4.98; 95% confidence interval, 1.13-22.01). Receiver operating characteristic analyses demonstrated that BPRI had superior predictive performance for these outcomes compared with sequential organ failure assessment and acute physiology score. Lower BPRI values were independently associated with adverse in-hospital outcomes after CA, including higher mortality and an increased risk of acute kidney injury. BPRI may serve as a simple and practical prognostic marker to support clinical decision-making in post-resuscitation care.