Cardiac arrest & resuscitation
Early post-ROSC laboratory phenotypes and clinical outcomes after out-of-hospital cardiac arrest: a 10-year national cohort study
Authors' conclusion
Early post-ROSC laboratory data identified three prognostically distinct phenotypes among resuscitated OHCA patients. These exploratory findings support external validation and investigation of phenotype-guided therapies.
Study context
- Population
- Adult resuscitated out-of-hospital cardiac arrest (OHCA) patients of presumed cardiac etiology, Singapore, between 01/02/2011 and 01/01/2022eligible patients (median age 65.0 years, 73.6% males)
- Participants
- 1,514 participants
- Exposure
- Homeostatic (HOM) and immune-dysregulated (IMD) phenotypes compared to multi-organ dysfunction (MOD)
- MODn = 286reference
- HOMn = 967
- IMDn = 261
- Outcome
- Poor neurological recovery
- Follow-up
- Hospital discharge
Methodological detailslinking Singapore's national OHCA and cardiovascular databases, Unsupervised latent class analysis (LCA), split-sample validation, adjusted for age, sex and initial cardiac rhythm
- Linking Singapore's national OHCA and cardiovascular databases
- Unsupervised latent class analysis (LCA)
- Split-sample validation
- Adjusted for age, sex and initial cardiac rhythm
Main finding
As reported in the abstract
Each group vs MODAdjusted odds ratio (95% CI)P value
HOM
0.50(0.30–0.78)
P = 0.004IMD
0.46(0.26–0.78)
P = 0.005Observational data: associations, not effects.
Further findings
| Outcome | aHR (95% CI) | P value | |
|---|---|---|---|
| 30-day mortalityHOM vs MOD | 0.71 (0.61–0.83) | all p ≤ 0.01 | |
| 30-day mortalityIMD vs MOD | 0.78 (0.64–0.94) | all p ≤ 0.01 | |
| 3-year mortalityHOM vs MOD | 0.70 (0.60–0.82) | all p ≤ 0.01 | |
| 3-year mortalityIMD vs MOD | 0.74 (0.62–0.90) | all p ≤ 0.01 | |
| 0.512Adjusted hazard ratio (log scale) |
Phenotype reproducibility (split-sample validation)
- Derivation entropy
- 0.817
- Replication entropy
- 0.892
Most discriminative variables
- Creatinine, eosinophil and lymphocyte
Original publication
Early post-ROSC laboratory phenotypes and clinical outcomes after out-of-hospital cardiac arrest: a 10-year national cohort study. Resuscitation. Published 9 October 2026. doi:10.
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