Acute cardiac care & resuscitation
Long-term neurological outcomes after extracorporeal cardiopulmonary resuscitation for refractory cardiac arrest: a 14-year single-centre cohort study
Authors' conclusion
These results emphasise the importance of establishing pre-treatment selection criteria to optimise ECPR use and enhance long-term neurological outcomes. Age, initial rhythm, and low-flow time are key determinants, and exploratory phenotype-based analyses suggest multidimensional patient characterisation may complement traditional selection criteria.
Study context
- Population
- Adult patients treated with Extracorporeal Cardiopulmonary Resuscitation (ECPR) for in-hospital (IHCA) and out-of-hospital (OHCA) refractory cardiac arrest (r-CA) at an Italian Extracorporeal Membrane Oxygenation (ECMO) centre between 2011 and 2024IHCA 117 · OHCA 178
- Participants
- 295 consecutive patients
- Exposure
- IHCA vs OHCA
- IHCAn = 117
- OHCAn = 178
- Outcome
- Long-term neurological performance: CPC 1-2
- Follow-up
- Six months after hospital discharge
Methodological detailssingle Italian ECMO centre, consecutive patients, multivariable and latent class analyses
- Single Italian ECMO centre
- Consecutive patients
- Multivariable and latent class analyses
Main finding
As reported in the abstract
P < 0.0001
- Overall Cerebral Performance Category (CPC) 1-2 at six months
- 17.3%
- Survived with severe long-term neurological sequelae (CPC 3-4)
- 4.4%
Observational data: associations, not effects.
Further findings
| Outcome | Estimate | |
|---|---|---|
| Independent predictors of CPC 1-2 — age · younger age | OR 0.95 per year (95% CI 0.92–0.98) | |
| Independent predictors of CPC 1-2 — low-flow duration · shorter low-flow duration | OR 0.95 per minute increase (95% CI 0.93–0.97) | |
| 0.512Odds ratio (log scale) |
Independent predictors of CPC 1-2
| Comparison | aOR (95% CI) | |
|---|---|---|
| Initial shockable rhythm | 2.7 (1.11–7.04) | |
| 0.10.31310Adjusted odds ratio (log scale) |
Stepwise selection based on predictors
- Progressively increased the proportion of favourable survivors but excluded a small proportion who might have recovered
Original publication
Long-term neurological outcomes after extracorporeal cardiopulmonary resuscitation for refractory cardiac arrest: a 14-year single-centre cohort study. Resuscitation. Published 16 April 2026. doi:10.
Summarised from the published abstract; every number is checked against it