Year: 2025
Type: article
Study design: Observational Study
Abstract: Background/Objectives: In-hospital cardiac arrest (IHCA) carries high mortality and substantial risk of neurological and functional impairment. Given that contemporary, clinically relevant risk models remain limited, especially within Southern European systems, the aim of this study was to develop a process-aware model for bedside risk stratification. Methods: We retrospectively analyzed a single-center cohort from a prospectively maintained resuscitation registry (AHEPA University General Hospital, Thessaloniki). Adults (≥18 years) with index IHCA in 2017–2019 were included. Utstein-defined variables underwent univariable screening, LASSO selection, and collinearity checks before multivariable logistic regression for in-hospital mortality. We assessed discrimination (AUC) and calibration (Hosmer–Lemeshow). Results: Among 826 IHCAs, 137 survived to discharge and 689 died. Higher mortality was independently associated with longer CPR (aOR = 1.115, 95% CI: 1.080–1.158), older age (aOR = 1.034, 95% CI: 1.014–1.055), and CCU location (aOR = 7.303, 95% CI: 2.557–25.798), while operating room (aOR = 0.029, 95% CI: 0.003–0.252), ICU/HDU (aOR = 0.203, 95% CI: 0.065–0.630), and an initial shockable rhythm (aOR = 0.297, 95% CI: 0.144–0.611) were protective. Longer time to CPR initiation also predicted mortality (aOR = 1.746, 95% CI: 1.001–3.162). Model performance was strong (AUC = 0.897, 95% CI: 0.865–0.928) with good calibration (Hosmer–Lemeshow p = 0.879). Conclusions: A process-aware model integrating patient factors, intra-arrest metrics, and location showed excellent internal performance for predicting IHCA mortality. Findings reaffirm the prognostic importance of age, rhythm, and resuscitation timeliness/intensity and support future work extending prediction to neurological/functional outcomes and testing targeted care bundles in high-risk strata.
Source: Journal of Clinical Medicine
DOI: 10.3390/jcm14217868
Authors: Maria Aggou, Barbara Fyntanidou, Andreas S. Papazoglou, Marios G. Bantidos, Nikolaos Vasileiadis, Dimitrios Vasilakos, Haralampos Karvounis, Dimitrios V. Moysidis, Athina Nasoufidou, Panagiotis Stachteas, Paschalis Karakasis, Konstantinos Fortounis, Eleni Argyriadou, Efstratios Karagiannidis, Vasilios Grosomanidis
Language: English
Subfield: Emergency Medicine
Field: Medicine
Domain: Health Sciences
Open Access status: gold
Estimated APC paid: $3,137
OpenAlex ID: W4415932707