Predicting Mortality in Patients With Return of Spontaneous Circulation After Cardiac Arrest

Predictors of In-Hospital Mortality in Patients With Return of Spontaneous Circulation After Cardiac Arrest: A Retrospective Observational Cohort Study

This retrospective observational cohort study aims to identify early predictors of short- and mid-term mortality in adult patients who achieved return of spontaneous circulation (ROSC) after cardiac arrest. Eligible patients admitted to the intensive care unit between January 1, 2024 and May 31, 2025 were identified retrospectively from electronic medical records following institutional ethics approval. Clinical, biochemical, and resuscitation-related parameters recorded within the first 24 hours of ICU admission were analyzed. The primary objective was to determine factors independently associated with short-term mortality. Six-month mortality was additionally assessed using hospital records and the national death registry. The findings are expected to improve risk stratification and clinical decision-making in post-cardiac arrest care.

This retrospective observational cohort study was conducted in the intensive care unit (ICU) of Gazi Yaşargil Training and Research Hospital, Turkey. Adult patients (≥18 years) who achieved return of spontaneous circulation (ROSC) after cardiac arrest and were admitted to the ICU between January 1, 2024 and May 31, 2025 were identified retrospectively from electronic medical records following institutional ethics approval.

Baseline demographic, clinical, laboratory, and resuscitation-related variables recorded within the first 24 hours of ICU admission were extracted from hospital records. These variables included arrest characteristics, time to ROSC, initial rhythm, hemodynamic parameters, neurological status, laboratory biomarkers, and therapeutic interventions routinely performed in ICU practice.

The primary outcome was 30-day all-cause mortality. Secondary outcomes included 24-hour, 7-day, and 6-month mortality, neurological outcome at hospital discharge, and ICU length of stay. Six-month mortality status was confirmed using hospital records and the national death registry.

A total of 168 eligible patients were identified during the study period. Multivariate logistic regression analysis was performed to identify independent predictors of mortality. No interventions beyond routine clinical care were conducted.

Inclusion Criteria:

• Age ≥ 18 years
• Achieved return of spontaneous circulation (ROSC) after cardiac arrest
• Admitted to the intensive care unit (ICU)
• Informed consent obtained from patient or legal representative (if applicable)

Exclusion Criteria:

• Age < 18 years
• Known pregnancy
• Brain death at the time of ICU admission
• Patients with missing key clinical or laboratory data
• Declined participation or legal refusal