Intensive & critical care nursing · 2026
Long-term survival following in-hospital cardiac arrest in patients admitted to the intensive care unit: A matched cohort study.
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Oh Jaehoon, Yoo Kyung Hun, Choi Nayeon, Lee Juncheol, Kim Jinsoo, Na Seunggu, Lee Sang Hwan, Cho Yongil
Аннотация
OBJECTIVES: Survival after in-hospital cardiac arrest (IHCA) has improved; however, long-term outcomes among patients who experience IHCA during intensive care unit (ICU) admission and survive to hospital discharge remain poorly defined. This study aimed to evaluate the long-term survival of patients who experienced IHCA during ICU admission.
METHODS: This population-based cohort study included adult patients admitted to the ICUs between 2015 and 2019. Patients who experienced IHCA during ICU admission and survived to discharge were compared with ICU patients who did not experience IHCA. Propensity score matching (PSM) was performed at a 1:3 ratio based on age, sex, Charlson Comorbidity Index, and ICU interventions. Long-term mortality was evaluated using Kaplan-Meier analysis and Cox regression with additional adjustment for socioeconomic and hospital-related factors. Time-interval analysis assessed temporal changes in mortality risk after discharge.
RESULTS: After PSM, 80,908 patients were included. During a follow-up of up to 9 years, survival was significantly lower in the IHCA group than in matched controls (log-rank p < 0.001). One-year survival rates were 0.47 (95% CI: 0.46-0.47) and 0.70 (95% CI: 0.70-0.71) in the IHCA and non-IHCA groups, respectively. IHCA during ICU admission was independently associated with higher long-term mortality (adjusted hazard ratio [aHR], 1.72; 95% CI: 1.68-1.75). Excess risk was greatest within the first 6 months after discharge (aHR, 2.35; 95% CI: 2.29-2.41) and gradually attenuated thereafter, remaining significant for up to 2 years.
CONCLUSIONS: IHCA during ICU admission was associated with higher long-term mortality than matched ICU controls. The early post-discharge period represents a period of particularly high mortality risk and may warrant closer clinical attention.
IMPLICATIONS FOR CLINICAL PRACTICE: These findings highlight the need to recognize ICU survivors of IHCA as a high-risk population. Further studies are needed to determine whether structured post-discharge follow-up can improve long-term outcomes.
METHODS: This population-based cohort study included adult patients admitted to the ICUs between 2015 and 2019. Patients who experienced IHCA during ICU admission and survived to discharge were compared with ICU patients who did not experience IHCA. Propensity score matching (PSM) was performed at a 1:3 ratio based on age, sex, Charlson Comorbidity Index, and ICU interventions. Long-term mortality was evaluated using Kaplan-Meier analysis and Cox regression with additional adjustment for socioeconomic and hospital-related factors. Time-interval analysis assessed temporal changes in mortality risk after discharge.
RESULTS: After PSM, 80,908 patients were included. During a follow-up of up to 9 years, survival was significantly lower in the IHCA group than in matched controls (log-rank p < 0.001). One-year survival rates were 0.47 (95% CI: 0.46-0.47) and 0.70 (95% CI: 0.70-0.71) in the IHCA and non-IHCA groups, respectively. IHCA during ICU admission was independently associated with higher long-term mortality (adjusted hazard ratio [aHR], 1.72; 95% CI: 1.68-1.75). Excess risk was greatest within the first 6 months after discharge (aHR, 2.35; 95% CI: 2.29-2.41) and gradually attenuated thereafter, remaining significant for up to 2 years.
CONCLUSIONS: IHCA during ICU admission was associated with higher long-term mortality than matched ICU controls. The early post-discharge period represents a period of particularly high mortality risk and may warrant closer clinical attention.
IMPLICATIONS FOR CLINICAL PRACTICE: These findings highlight the need to recognize ICU survivors of IHCA as a high-risk population. Further studies are needed to determine whether structured post-discharge follow-up can improve long-term outcomes.