Age-Dependent Benefit of ECPR in OHCA: An Interaction Analysis

ECPR effectiveness in OHCA remains inconsistent, and age-related effect modification is not well defined. This retrospective study analyzed 470 adult patients (2011-2025), comparing ECPR (n=71) to CCPR (n=399). Using multivariable regression and inverse probability of treatment weighting (IPTW), we found that increasing age independently associated with higher mortality (aOR: 1.064). Also, a significant interaction between age and treatment strategy was identified (p<0.001). ECPR provided a substantial mortality reduction in younger patients, but this benefit progressively attenuated with age. These findings demonstrate that ECPR effectiveness is strongly age-dependent. Consequently, age should be considered as a continuous effect modifier rather than a rigid eligibility threshold for ECPR selection.