The Association Between Alkaline Phosphatase and Neurological Outcome in Patients with Post-cardiac Arrest: a Secondary Analysis of Data from Belgium

Abstract

Background: Prognostication of the unfavourable neurological outcome(UNO) after Cardiac arrest(CA) is multimodal while blood biomarkers are an attractive option.Serum alkaline phosphatase(ALP) is shown to be associated with ischemic stroke and considered as an independent prognostic factor for long-term functional outcome after acute cerebral infarction.We aimed to study the association between ALP and UNO in 3 months in patients after CA.Methods:Review of consecutive patients admitted to the ICU at Erasme Hospital, Brussels (Belgium) following CA between January 2007 and December 2015. The outcome was the UNO in 3 months. We used multivariable logistic regression models to calculate the adjusted odd ratio (OR) with 95% confidence interval(CI). Interaction and stratified analyses were conducted according to Shock,Dobutamine.used,Hypertension,Cardiac.Etiology and Shockable.Rhythm.Results: We included 374 CA patients. The multivariate logistic regression analyses revealed that the risk of UNO in 3 months after CA was significantly associated with ALP.When ALP was Equal is divided in 3 groups, the risk of ALP>91 level and adverse outcomes was 1.7407 times of ALP<64 level (P for trend=0.19709).In the non-hypertension group, the risk of adverse outcomes increased with increased ALP by 1.018 (1.0041.01,1.032).Conclusions: ALP is an independent risk factor for the UNO in 3 months after CA, especially in non-hypertension. Elevated ALP was significantly associated with increased UNO in 3 months after CA. However, the prediction significance of ALP for long-term neurological outcome in patients after CA is needed further studied.