Table 1 The summary of reviewed studies’ characteristics
Ref | Inclusion criteria | Exclusion criteria | Number of patients | Location of cardiac arrest | Survival rate [%] 1At discharge from hospital 2After 30 days | Percentage of patients with a favorable outcome [%] assessed with Cerebral Performance Categories scale 1At discharge from hospital 2After 30 days | Examined factors |
|---|---|---|---|---|---|---|---|
[17] | • witnessed, refractory OHCA or IHCA • patients hospitalized between January 2007 and December 2016 | • cardiogenic shock after cardiac arrest receiving ECLS without cardiac massage • OHCA due to hypothermia (< 32 °C) | 131 | IHCA and OHCA | 10.41 | 6.41 | • age • sex • low-flow time > 30 min • pH • shockable rhythm |
[18] | • OHCA • patients hospitalized between January 2006 and May 2019 • ≥ 18 years old | • eCPR performed in another institution • unwitnessed CA • incomplete follow-up data | 136 | OHCA | 36.81 | 25.71 | • hypoxic brain injury on CT • age • age > 75 years old • Charlson’s comorbidity index • sex • low-flow time • low-flow time > 60 min • ECMO to CT time • dialysis • initial serum creatinine • initial eGFR • initial lactate level |
[22] | • patients hospitalized between May 2004 and December 2018 • ≥ 18 years old | • lack of liver function laboratory data | 365 | IHCA and OHCA | 45.22 | 32.91 | • presence of hypoxic hepatitis Definition: increased > 20 times upper the normal range ALT or AST serum level (ALT > 820 IU/l, AST > 800 IU/l) occurring from day 0 to day 2 |
[19] | • patients hospitalized between June 2014 and December 2017 (JAAM-OHCA registry) • ≥ 18 years old • shockable rhythm (VF or pVT) | • traumatic cause of CA • no resuscitation attempt in hospital • DNR order • patients transported to the participating hospitals after receiving any treatment at other hospitals • ROSC at hospital arrival • no pre-hospital data | Development cohort: 458 | OHCA | - | Development cohort: 12.42 | • age 18–64 / ≥ 75 years old • age 65–74 / ≥ 75 years old • witnessed CA • bystander CPR • shockable initial rhythm • shockable rhythm on hospital arrival • time from call to hospital arrival ≤ 25 / > 25 min • time from call to hospital arrival ≤ 30 / > 30 min • time from call to hospital arrival ≤ 35 / > 35 min • initial pH on hospital arrival ≥ 7.0 / < 7.0 • initial pH on hospital arrival ≥ 6.9 / < 6.9 • initial pH on hospital arrival ≥ 6.8 / < 6.8 |
Validation cohort: 458 | Validation cohort: 12.42 TiPS65 score = 0: 1.6 TiPS65 score = 1: 4.4 TiPS65 score = 2: 12.5 TiPS65 score = 3–4: 30.8 | TiPS65 score values*: • 1 point • 2 points • 3 points • 4 points *1 point for each: time from call to hospital ≤ 25 min; initial pH on hospital arrival ≥ 7.0; shockable rhythm on hospital arrival; < 65 years old | |||||
[23] | • ≥ 18 years old • refractory CA (lack of ROSC after 20–30 min of conventional CPR) | • CA caused by trauma, severe hypothermia (< 32 °C) • cardiogenic shock after ROSC • pregnancy | 434 | OHCA | 15.92 | 14.52 | Sign of life before or throughout CPR: • gasping (any abnormal breathing pattern) • pupillary light reaction (presence or recovery of any pupillary response assessed visually by pen light examination by a physician, other than bilateral non-reactive dilated pupils) • increased level of consciousness (spontaneous eye opening, increased jaw tone, swallowing, speech, or other body movement) • any sign of life before or throughout CPR |
[24] | • patients hospitalized between January 2013 and December 2018 (SAVE-J II registry) • ≥ 18 years old | • patients transferred from another hospital • sustained ROSC when ECMO was initiated • non-cardiac etiology of CA such as acute aortic syndromes, hypothermia, primary cerebral disorders, infection, drug intoxication, trauma, suffocation, drowning • hospital arrival to ECMO initiation time > 60 min • missing data on transient ROSC, timing of ROSC, CA to ECMO initiation time interval, and outcomes | 1501 | OHCA | 29.01 | 14.7 | • presence and timing of transient ROSC Definition: any palpable pulse or measurable blood pressure ≥ 1 min before ECMO initiation either before or after hospital arrival |
[14] | • patients hospitalized between January 2018 and December 2019 (JAAM-OHCA registry) • ≥ 18 years old • shockable rhythm (VF or pVT confirmed by paramedics at the scene or at hospital arrival, defibrillated by bystander with AED or by paramedics before hospital arrival) | • traumatic cause of CA • no resuscitation attempt in hospital • DNR order • patients transported to the participating hospitals after receiving any treatment at other hospitals • ROSC at hospital arrival • no pre-hospital data | 590 | OHCA | 26.02 | Total: 10.82 TiPS65 score = 0: 0.0 TiPS65 score = 1: 3.1 TiPS65 score = 2: 12.2 TiPS65 score = 3: 18.2 TiPS65 score = 4: 42.3 | TiPS65 score cut-off values*: • > 0 points • > 1 point • > 2 points • > 3 points *1 point for each: time from call to hospital ≤ 25 min; initial pH on hospital arrival ≥ 7.0; shockable rhythm on hospital arrival; < 65 years old |
[21] | • patients hospitalized between June 2014 and December 2021 (JAAM-OHCA registry) • ≥ 18 years old • non-shockable initial rhythm | • traumatic cause of CA • not in CA at the initial contact by EMS • patients who were not resuscitated by paramedics • no resuscitation attempt in hospital • ROSC at hospital arrival • no pre-hospital data | 370 | OHCA | 11.12 | Total: 4.12 TiPS65 score = 0: 5.2 TiPS65 score = 1: 4.2 TiPS65 score = 2: 0.9 TiPS65 score = ≥ 3: 11.4 | TiPS65 score elements: • time from call to hospital ≤ 25 min • initial pH on hospital arrival ≥ 7.0 • shockable rhythm on hospital arrival • < 65 years old |
[25] | • patients hospitalized between January 2013 and December 2018 (SAVE-J II registry) • ≥ 18 years old | • implementation of ECMO after admission to ICU • ECMO withdrawn after cannulation because of ROSC • ROSC on hospital arrival or at ECMO initiation • CA started in an ambulance or after arriving at the hospital • unknown CA location • patients transferred from another hospital | 1744 | OHCA | 25.01 | 13.01 | • location of OHCA (residential vs. public) |
[20] | • patients hospitalized between January 2013 and December 2018 (SAVE-J II registry) • ≥ 18 years old | • implementation of ECMO after admission to ICU • all cases with ROSC • ECMO withdrawn after cannulation because of ROSC • patients transferred from another hospital • unknown outcome | 1781 | OHCA | 24.51 | 12.71 | • age • sex • witnessed CA • bystander CPR • initial cardiac rhythm at the scene • pre-hospital intervention (defibrillation, adrenaline administration) • initial cardiac rhythm on hospital arrival • ambulance call to hospital arrival time • hospital arrival to ECMO time • ambulance call to ECMO time • CA to ECMO interval • emergency coronary angiograph • percutaneous coronary intervention • Intra-aortic balloon pump • CA etiology (cardiac causes, acute aortic dissection/aneurysm, pulmonary embolism, primary cerebral disorders, infections, other medical causes, accidental hypothermia, poisoning, trauma, suffocation, other nonmedical causes) |