Cardiac arrest & resuscitation
Sub-phenotypes in patients with out-of-hospital cardiac arrest who undergo extracorporeal cardiopulmonary resuscitation: a retrospective observational study from a multicenter registry
Authors' conclusion
Three clinically meaningful sub-phenotypes were identified using simple pre-hospital and in-hospital factors, with low-flow time emerging as the most critical discriminating factor. The sub-phenotypes showed significant associations with clinical outcomes and provide a practical framework for ECPR patient stratification.
Study context
- Population
- Adults with out-of-hospital cardiac arrest (OHCA) who received extracorporeal cardiopulmonary resuscitation (ECPR), Japanese Association for Acute Medicine OHCA registry, 83 hospitals, June 2014–December 2020
- Participants
- 1,528 adults · 83 hospitals
- Exposure
- Delayed ECPR and Non-shockable Rhythm sub-phenotypes vs Standard ECPR sub-phenotype
- Standard ECPRn = 702reference
- Delayed ECPRn = 457
- Non-shockable Rhythmn = 369
- Outcome
- 30-day survival
- Follow-up
- 30 days
Methodological detailsmulticentre registry, latent class analysis
- Multicentre registry
- Latent class analysis
Main finding
As reported in the abstract
30-day survival by sub-phenotype
Each group vs standard ECPRAOR for 30-day survival (95% CI)
Delayed ECPR
0.61(0.44–0.82)
Non-shockable Rhythm
0.47(0.32–0.68)
Observational data: associations, not effects.
Further findings
- Favorable neurological outcome · 30 days — Standard ECPR
- 12.1%
- Favorable neurological outcome — Differed significantly among sub-phenotypes; highest in Standard ECPR
- p = 0.004
Overall cohort
- Median low-flow time 47 min (IQR 38-58 min)
- 47
- 30-day survival rate, eligible patients
- 20.9%
- Most discriminative latent class analysis (LCA) variable: low-flow time, then pre-hospital shock delivery and initial cardiac rhythm
Original publication
Sub-phenotypes in patients with out-of-hospital cardiac arrest who undergo extracorporeal cardiopulmonary resuscitation: a retrospective observational study from a multicenter registry. Crit Care. Published 22 July 2025. doi:10.
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