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<p>Twelve-lead electrocardiogram (ECG) may provide prognostic information for in-hospital cardiac arrest (IHCA). This study aimed to identify post-arrest ECG features and their temporal changes associated with IHCA outcomes. This single-center retrospective study included patients experiencing IHCA between 2005 and 2022. Post-arrest ECGs were obtained within 48&#xa0;h after an IHCA, admission ECGs upon hospital admission, and pre-arrest ECGs within 72&#xa0;h before an IHCA. Multivariable logistic regression analyses were conducted to identify ECG features associated with neurologically intact survival. A total of 708 patients were included, with 131 (18.5%) achieving neurologically intact survival. The median age was 70.4&#xa0;years (interquartile range: 59.2–82.6), and 362 (62.7%) patients were male. Four post-arrest ECG features were associated with survival: sinus rhythm (odds ratio [OR]: 1.81, 95% confidence interval [CI]: 1.11–2.93), QRS duration between 80 and 120&#xa0;ms (OR: 1.91, 95% CI 1.19–3.08), low QRS voltage (OR: 0.50, 95% CI 0.25–0.99), and prolonged QTc (OR: 1.89, 95% CI 1.08–3.28). Comparing with admission ECGs, new-onset right bundle branch block (OR: 0.39, 95% CI 0.16–0.95) and increases in the number of leads with ST depression (OR: 0.85, 95% CI 0.77–0.94) on post-arrest ECGs were inversely associated with survival. Compared with pre-arrest ECGs, increases in the number of leads with ST depression (OR: 0.91, 95% CI 0.88–0.96) on post-arrest ECGs were also inversely associated with survival. Post-arrest ECGs may serve as a valuable prognostic tool for IHCA. Further exploration is warranted to determine whether incorporating these ECG features can enhance the performance of prediction models for IHCA outcomes.</p>

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Association between post-arrest 12-lead electrocardiographic features and neurologically intact survival for patients of in-hospital cardiac arrest

  • 期刊论文

  • 发表日期：

    2025年4月2日

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  • Chih-Hung Wang,
  • Cheng-Yi Wu,
  • Joyce Tay,
  • Meng-Che Wu,
  • Li-Ting Ho,
  • Wei-Han Lin,
  • Jr-Jiun Lin,
  • Huang-Fu Yeh,
  • Chu-Lin Tsai,
  • Chien-Hua Huang,
  • Wen-Jone Chen

摘要

Twelve-lead electrocardiogram (ECG) may provide prognostic information for in-hospital cardiac arrest (IHCA). This study aimed to identify post-arrest ECG features and their temporal changes associated with IHCA outcomes. This single-center retrospective study included patients experiencing IHCA between 2005 and 2022. Post-arrest ECGs were obtained within 48 h after an IHCA, admission ECGs upon hospital admission, and pre-arrest ECGs within 72 h before an IHCA. Multivariable logistic regression analyses were conducted to identify ECG features associated with neurologically intact survival. A total of 708 patients were included, with 131 (18.5%) achieving neurologically intact survival. The median age was 70.4 years (interquartile range: 59.2–82.6), and 362 (62.7%) patients were male. Four post-arrest ECG features were associated with survival: sinus rhythm (odds ratio [OR]: 1.81, 95% confidence interval [CI]: 1.11–2.93), QRS duration between 80 and 120 ms (OR: 1.91, 95% CI 1.19–3.08), low QRS voltage (OR: 0.50, 95% CI 0.25–0.99), and prolonged QTc (OR: 1.89, 95% CI 1.08–3.28). Comparing with admission ECGs, new-onset right bundle branch block (OR: 0.39, 95% CI 0.16–0.95) and increases in the number of leads with ST depression (OR: 0.85, 95% CI 0.77–0.94) on post-arrest ECGs were inversely associated with survival. Compared with pre-arrest ECGs, increases in the number of leads with ST depression (OR: 0.91, 95% CI 0.88–0.96) on post-arrest ECGs were also inversely associated with survival. Post-arrest ECGs may serve as a valuable prognostic tool for IHCA. Further exploration is warranted to determine whether incorporating these ECG features can enhance the performance of prediction models for IHCA outcomes.