Acute cardiac care & resuscitation
Defining three coagulation-based phenotypes for out-of-hospital cardiac arrest (OHCA) patients undergoing extracorporeal cardiopulmonary resuscitation (ECPR): an unsupervised cluster analysis
Main finding · SurvivalResult — go to the resultOR for survival 0.25 95% CI 0.12–0.55Authors' conclusion
Three distinct coagulation phenotypes at ECPR initiation were independently associated with survival and neurological outcome and appear to reflect ischaemic injury severity. These findings require validation in independent cohorts before clinical application.
Study context
- Population
- Refractory out-of-hospital cardiac arrest (OHCA) patients treated with extracorporeal cardiopulmonary resuscitation (ECPR), 2013–2024of 406 ECPR patients, those with coagulation data for analysis
- Participants
- 360 participants
- Comparison
- Coagulation phenotypes identified at ECPR initiation, compared for survival, neurological outcomes and complications; phenotype 2 versus phenotype 3 on multivariable analysis
- Phenotype 1n = 49
- Phenotype 2n = 175
- Phenotype 3n = 136reference
- Outcome
- Survival
Methodological detailsconsecutive refractory OHCAs treated with ECPR (2013-2024), multivariable logistic regression
- Consecutive refractory OHCAs treated with ECPR (2013-2024)
- Multivariable logistic regression
Main finding
As reported in the abstract
OR for survival
0.25
95% CI 0.12–0.55
By group
Phenotype 2vs Phenotype 3
OR for survival 0.25 (95% CI 0.12–0.55)
Further findings
| Outcome | Phenotype 1 | Phenotype 2 | Phenotype 3 | OR for favourable neurological outcome (95% CI) | |
|---|---|---|---|---|---|
| Favourable neurological outcomePhenotype 2vs Phenotype 3Multivariable analysis | 0% | 5.1% | 17.6% | 0.31 (0.12–0.81) | |
| 0.10.31310OR for favourable neurological outcome (log scale) |
Ischaemic burden (lactate, arterial pH, end-tidal CO2, and low-flow duration)
- Phenotype severity correlated with ischaemic burden
Safety
Bleeding incidence rate
- Bleeding incidence rate: all p < 0.001
Original publication
Defining three coagulation-based phenotypes for OHCA patients undergoing ECPR: an unsupervised cluster analysis. Eur Heart J Acute Cardiovasc Care. Published 26 October 2026. doi:10.
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