Introduction. The aim of our study was to explore the associations of the aspartate transaminase/alanine transaminase (De-Ritis) ratio with outcomes after cardiac arrest (CA). Methods. This retrospective study included 374 consecutive adult cardiac arrest patients. Information on the study population was obtained from the Dryad Digital Repository. Patients were divided into tertiles based on their De-Ritis ratio. The logistic regression hazard analysis was used to assess the independent relationship between the De-Ritis ratio and mortality. The Kaplan-Meier method and log-rank test were used to estimate the survival of different groups. Receiver operating characteristic (ROC) curve analysis was utilized to compare the prognostic ability of biomarkers. A model combining the De-Ritis ratio was established, and its performance was evaluated using the Akaike information criterion (AIC). Results. Of the 374 patients who were included in the study, 194 patients (51.9%) died in the intensive care unit (ICU), 213 patients (57.0%) died during hospitalization, and 226 patients (60.4%) had an unfavorable neurologic outcome. Logistic regression analysis including potentially confounding factors showed that the De-Ritis ratio was independently associated with mortality, yielding a more than onefold risk of ICU mortality (OR 1.455; 95% CI 1.088-1.946; ) and hospital mortality (OR 1.378; 95% CI 1.031-1.842; ). Discriminatory performance assessed by ROC curves showed an area under the curve of 0.611 (95% CI 0.553-0.668) for ICU mortality and 0.625 (0.567-0.682) for hospital mortality. Further, the likelihood ratio test (LRT) analysis showed that the model combining the De-Ritis ratio had a smaller AIC and higher likelihood ratio score than the model without the De-Ritis ratio. The Kaplan-Meier curves showed that the CA patients in the De-Ritis ratio tertile 3 group clearly had a significantly higher incidence of ICU mortality (). Conclusion. An elevated De-Ritis ratio on admission was significantly associated with ICU mortality and hospital mortality after CA. Assessment of the De-Ritis ratio might help identify groups at high risk for mortality.

中文翻译：

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De-Ritis 比率与心脏骤停后的死亡率相关

简介。我们研究的目的是探讨天冬氨酸转氨酶/丙氨酸转氨酶 (De-Ritis) 比率与心脏骤停 (CA) 后结局的关系。方法. 这项回顾性研究包括 374 名连续成年心脏骤停患者。研究人群的信息来自 Dryad Digital Repository。根据他们的 De-Ritis 比率将患者分为三组。Logistic回归风险分析用于评估De-Ritis比率与死亡率之间的独立关系。Kaplan-Meier方法和对数秩检验用于估计不同组的存活率。接受者操作特征（ROC）曲线分析用于比较生物标志物的预后能力。建立了结合De-Ritis比率的模型，并使用Akaike信息准则（AIC）对其性能进行了评估。结果. 在纳入研究的 374 名患者中，194 名患者（51.9%）死于重症监护病房（ICU），213 名患者（57.0%）在住院期间死亡，226 名患者（60.4%）的神经系统预后不良。包括潜在混杂因素的逻辑回归分析表明，De-Ritis 比率与死亡率独立相关，导致 ICU 死亡率的风险超过一倍（OR 1.455；95% CI 1.088-1.946；)和住院死亡率 (OR 1.378; 95% CI 1.031-1.842;）。ROC 曲线评估的判别性能显示，ICU 死亡率曲线下面积为 0.611（95% CI 0.553-0.668），住院死亡率曲线下面积为 0.625（0.567-0.682）。此外，似然比检验 (LRT) 分析表明，与没有 De-Ritis 比的模型相比，结合 De-Ritis 比的模型具有更小的 AIC 和更高的似然比得分。Kaplan-Meier 曲线显示，De-Ritis 比率三分位数 3 组的 CA 患者明显具有显着更高的 ICU 死亡率发生率。）。 结论。入院时 De-Ritis 比率升高与 CA 后 ICU 死亡率和住院死亡率显着相关。评估 De-Ritis 比率可能有助于识别死亡率高的人群。