Acute cardiac care & resuscitation
Neurologic etiologies of cardiac arrest are associated with early withdrawal of life-sustaining therapy
Main finding · SurvivalResult — go to the resultOdds ratio 0.39 95% CI 0.21–0.70Authors' conclusion
Neurologic etiologies of cardiac were associated with worse functional outcomes and increased in-hospital mortality. Early mortality among patients with neurologic arrest etiologies was driven by withdrawal of life-sustaining treatment for perceived poor neurologic prognosis, suggesting prognostic nihilism.
Study context
- Population
- Patients resuscitated from cardiac arrestof whom 158 (3.6%) arrested from neurologic causes
- Participants
- 4,414 patients
- Exposure
- Patients with vs without neurologic arrest etiologies
- Neurologic arrest etiologiesn = 158
- Outcome
- Survival
Main finding
As reported in the abstract
Odds ratio
0.39
95% CI 0.21–0.70
Neurologic arrest etiologiesvs Non-neurologic arrest etiologies
OR 0.39 (95% CI 0.21–0.70)
Observational data: associations, not effects.
Further findings
| Outcome | HR (95% CI) | |
|---|---|---|
| Withdrawal of life-sustaining therapy for perceived poor neurologic prognosis (WLST-N) | 2.4 (1.87–3.15) | |
| 0.20.5125Hazard ratio (log scale) |
- Withdrawal of life-sustaining therapy for perceived poor neurologic prognosis (WLST-N): increased hazard of WLST-N with neurologic etiologies; Cox regression censoring for death from other cause and survival at hospital discharge
Functional outcomes
- Worse functional outcomes with neurologic arrest etiologies
- P < 0.001
Early (≤1 day from arrest) WLST-N
- Greater proportion with early WLST-N among neurologic arrest etiologies
- P < 0.001
- Fisher's exact test
Original publication
Neurologic etiologies of cardiac arrest are associated with early withdrawal of life-sustaining therapy. Resuscitation. Published 16 May 2025. doi:10.
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