Impact of Transitory ROSC Events on Neurological Outcome in Patients with Out-of-Hospital Cardiac Arrest

Area of Science:

• Emergency Medicine
• Cardiology
• Critical Care Medicine

Background:

• Out-of-hospital cardiac arrest (OHCA) presents significant survival challenges.
• Temporary return to spontaneous circulation (t-ROSC) is a known predictor of survival to hospital discharge.
• The impact of t-ROSC duration on OHCA outcomes remains underexplored.

Purpose of the Study:

• To investigate the duration of t-ROSC episodes in OHCA patients.
• To determine the association between t-ROSC duration and neurological outcome at hospital discharge.

Main Methods:

• Prospective observational study design.
• Analysis of defibrillator-recorded OHCA events using dedicated software.
• Recording of t-ROSC episode frequency and cumulative duration.
• Assessment of good neurological outcome at hospital discharge as the primary endpoint.

Main Results:

• Out of 285 OHCA patients, 45 (15.8%) experienced one or more t-ROSCs.
• t-ROSC occurrence was more frequent in patients with a shockable rhythm (p = 0.009).
• Cumulative t-ROSC duration was significantly longer in patients achieving sustained ROSC (p < 0.001).
• Adjusted cumulative t-ROSC length independently predicted good neurological outcome (OR 1.588, p = 0.042).

Conclusions:

• Temporary return to spontaneous circulation (t-ROSC) episodes during OHCA are a favorable prognostic factor.
• The cumulative duration of t-ROSC is an independent predictor of good neurological outcome.
• These findings support continuing resuscitation efforts in patients experiencing t-ROSC.