Objective：To investigate the predictive efficacy of laboratory indexes for the 30 - day risk of death in extracorporeal cardiopulmonary resuscitation（ECPR）patients prior to receiving support. Methods：A retrospective analysis was performed on 113 patients who received ECPR transfer for more than 24 hours at the Emergency and Critical Care Medicine Department of the First Affiliated Hospital of Nanjing Medical University between January 2018 and December 2023. The patients were categorized into two groups based on their 30-day survival rate：the survival group（n=44）and the death group（n=69）. The laboratory test indicators before ECPR enrollment were examined using univariate analysis and Kaplan -Meier analysis for each of these groups. Cox’s proportional hazards regression model was used in multivariate analysis to examine the laboratory test markers that showed statistically and clinically significant differences. Receiver operating characteristic（ROC）curves were used to plot the subject characteristics，and the area under the ROC curvewas calculated. Results：According to the multifactorial Cox analysis，lactate[HR（95%CI）：1.318（1.185- 1.467），P ＜ 0.05]，PaCO[2 HR（95%CI）：1.008（1.001-1.013），P ＜ 0.05]，Na[HR（95%CI）：1.068（1.022-1.116），P ＜ 0.05]， creatinine[HR（95%CI）：1.003（1.001-1.004），P ＜ 0.05]and activated partial thromboplastin time（APTT）[HR（95%CI）：1.001 （1.001-1.002），P ＜ 0.05]were among the risks associated with 30-day mortality in ECPR patients. Moreover，there may be preventive benefits for pH[HR（95%CI）：0.161（0.027-0.961），P ＜ 0.05]and fibrinogen（FIB）[HR（95%CI）：0.823（0.688-0.986），P ＜ 0.05]. Conclusion：In patients receiving ECPR，the primary risk factors linked to 30-day death are lactate，PaCO₂，Na，creatinine，and APTT，while pH and FIB may have a potential protective role.