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Cardiometabolic multimorbidity and survival after out-of-hospital cardiac arrest

Yue Li1, Nur Shahidah1,2, David Pflug3

  • 1Pre-hospital and Emergency Research Centre, Health Services Research & Population Health, Duke-NUS Medical School, Singapore.

Resuscitation Plus
|June 5, 2026
PubMed

Insights

Cardiometabolic multimorbidity significantly lowers survival rates after out-of-hospital cardiac arrest (OHCA). Managing these conditions upstream is crucial for improving OHCA outcomes and survival.

Area of Science:

  • Cardiology
  • Public Health
  • Epidemiology

Background:

  • Cardiometabolic multimorbidity, the presence of multiple cardiometabolic diseases, is a growing concern.
  • Its impact on outcomes following out-of-hospital cardiac arrest (OHCA) requires further investigation.

Purpose of the Study:

  • To assess the association between cardiometabolic multimorbidity and short-term outcomes in adult patients experiencing OHCA.
  • To evaluate the influence of the number of cardiometabolic conditions on OHCA survival.

Main Methods:

  • Analysis of a national registry of adult, non-traumatic OHCAs in Singapore (2010-2021).
  • Primary outcome: survival to hospital discharge. Secondary outcomes: pre-hospital return of spontaneous circulation (ROSC), survival to hospital admission, and survival with good neurological outcome.
  • Multivariable logistic regression models were employed, adjusting for Utstein covariates.

Main Results:

  • 60.2% of 20,475 OHCA patients had cardiometabolic multimorbidity.
  • Multimorbidity was linked to reduced odds of pre-hospital ROSC (aOR 0.78) and survival to hospital discharge (aOR 0.78).
  • Worse outcomes correlated with an increasing number of cardiometabolic conditions, particularly for pre-hospital ROSC and survival to discharge.

Conclusions:

  • Cardiometabolic multimorbidity is an independent predictor of poorer pre-hospital ROSC and survival to hospital discharge after OHCA.
  • A dose-response relationship exists, with more conditions leading to worse outcomes.
  • Emphasizes the need for upstream prevention of cardiometabolic diseases to enhance OHCA survival rates.
Abstract

Keywords:
Cardiometabolic multimorbidityDiabetesHypertensionNeurological recoveryOut-of-hospital cardiac arrestSurvival

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