Acute cardiac care & resuscitation

Extracorporeal life support in cardiac arrest: a post hoc Bayesian re-analysis of the INCEPTION trial

Eur Heart J Acute Cardiovasc CarePublished Secondary analysis of the INCEPTION randomised trial

Authors' conclusion

Bayesian re-analysis of the INCEPTION trial estimated a 42% probability of an MCID between ECPR and CCPR in refractory OHCA in terms of 30-day survival with a favourable neurologic outcome.

Study context

Population
Patients with refractory out-of-hospital cardiac arrest (OHCA)
Comparison
Extracorporeal cardiopulmonary resuscitation (ECPR) vs conventional cardiopulmonary resuscitation (CCPR)
Primary endpoint
Survival with favourable neurologic outcome (cerebral performance category 1-2)
Follow-up
30 days
Methodological detailspost hoc Bayesian re-analysis, multicentre, minimally informative prior, sensitivity analyses under sceptical and literature-based priors
  • Post hoc Bayesian re-analysis
  • Multicentre
  • Minimally informative prior
  • Sensitivity analyses under sceptical and literature-based priors

Primary result

As reported in the abstract

30-day survival with favourable neurologic outcome
ECPR vs CCPRMean ARD (95% CrI)
CrI; favouring ECPR
3.6%(−9.5-16.7%)
ECPR vs CCPRMedian relative risk (95% CrI)
CrI
1.22(0.59–2.51)
Posterior probability of minimal clinically important difference (MCID) (5% ARD) in favour of ECPR
42%

Further findings

Survival with favourable neurologic outcome · 6 months

Posterior probability of MCID (5% ARD) in favour of ECPR
42%

Original publication

Extracorporeal life support in cardiac arrest: a post hoc Bayesian re-analysis of the INCEPTION trial. Eur Heart J Acute Cardiovasc Care. Published 24 October 2023. doi:10.1093/ehjacc/zuad130

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