Evidence map›Paper›PMID 31801749›Full record

SynthesisBMJ (Clinical research ed.)2019

Pre-arrest and intra-arrest prognostic factors associated with survival after in-hospital cardiac arrest: systematic review and meta-analysis.

Shannon M Fernando, Alexandre Tran, Wei Cheng, Bram Rochwerg, Monica Taljaard, Christian Vaillancourt, Kathryn M Rowan, David A Harrison, Jerry P Nolan, Kwadwo Kyeremanteng and 3 more

Abstract readMeta-AnalysisSystematic Review
PubMed Full text at PMC Publisher
In one paragraph

Synthesis in BMJ (Clinical research ed.), 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 48 papers, 5 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
48citing papers in PubMed, 5 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

48 citing papers in PubMed, 5 syntheses or guidelines pooled it.

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  13. Predictors of immediate survival in Emergency Department cardiac arrest in Ethiopia: Insights from a resource-limited setting.African journal of emergency medicine : Revue africaine de la medecine d'urgence · 2025
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

13 authors.

Shannon M FernandoDivision of Critical Care, Department of Medicine, University of Ottawa, Ottawa, ON, Canada sfernando@qmed.ca.ORCID http://orcid.org/0000-0003-4549-4289
Alexandre TranSchool of Epidemiology and Public Health, University of Ottawa, Ottawa, ON, Canada.
Wei ChengClinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, ON, Canada.
Bram RochwergDivision of Critical Care, Department of Medicine, McMaster University, Hamilton, ON, Canada.
Monica TaljaardSchool of Epidemiology and Public Health, University of Ottawa, Ottawa, ON, Canada.
Christian VaillancourtDepartment of Emergency Medicine, University of Ottawa, Ottawa, ON, Canada.
Kathryn M RowanIntensive Care National Audit and Research Centre, London, UK.
David A HarrisonIntensive Care National Audit and Research Centre, London, UK.
Jerry P NolanDepartment of Anaesthesia and Intensive Care Medicine, Royal United Hospital, Bath, UK.
Kwadwo KyeremantengDivision of Critical Care, Department of Medicine, University of Ottawa, Ottawa, ON, Canada.
Daniel I McIsaacSchool of Epidemiology and Public Health, University of Ottawa, Ottawa, ON, Canada.
Gordon H GuyattDepartment of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, ON, Canada.
Jeffrey J PerryDepartment of Emergency Medicine, University of Ottawa, Ottawa, ON, Canada.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectiveTo determine associations between important pre-arrest and intra-arrest prognostic factors and survival after in-hospital cardiac arrest.

designSystematic review and meta-analysis. DATA SOURCES: Medline, PubMed, Embase, Scopus, Web of Science, and the Cochrane Database of Systematic Reviews from inception to 4 February 2019. Primary, unpublished data from the United Kingdom National Cardiac Arrest Audit database. STUDY SELECTION CRITERIA: English language studies that investigated pre-arrest and intra-arrest prognostic factors and survival after in-hospital cardiac arrest. DATA EXTRACTION: PROGRESS (prognosis research strategy group) recommendations and the CHARMS (critical appraisal and data extraction for systematic reviews of prediction modelling studies) checklist were followed. Risk of bias was assessed by using the QUIPS tool (quality in prognosis studies). The primary analysis pooled associations only if they were adjusted for relevant confounders. The GRADE approach (grading of recommendations assessment, development, and evaluation) was used to rate certainty in the evidence.

resultsThe primary analysis included 23 cohort studies. Of the pre-arrest factors, male sex (odds ratio 0.84, 95% confidence interval 0.73 to 0.95, moderate certainty), age 60 or older (0.50, 0.40 to 0.62, low certainty), active malignancy (0.57, 0.45 to 0.71, high certainty), and history of chronic kidney disease (0.56, 0.40 to 0.78, high certainty) were associated with reduced odds of survival after in-hospital cardiac arrest. Of the intra-arrest factors, witnessed arrest (2.71, 2.17 to 3.38, high certainty), monitored arrest (2.23, 1.41 to 3.52, high certainty), arrest during daytime hours (1.41, 1.20 to 1.66, high certainty), and initial shockable rhythm (5.28, 3.78 to 7.39, high certainty) were associated with increased odds of survival. Intubation during arrest (0.54, 0.42 to 0.70, moderate certainty) and duration of resuscitation of at least 15 minutes (0.12, 0.07 to 0.19, high certainty) were associated with reduced odds of survival.

conclusionModerate to high certainty evidence was found for associations of pre-arrest and intra-arrest prognostic factors with survival after in-hospital cardiac arrest. SYSTEMATIC REVIEW REGISTRATION: PROSPERO CRD42018104795.

Indexed as

Hospital MortalityAdultFemaleHeart ArrestHumansMaleOdds RatioPrognosisRisk AssessmentRisk FactorsSex FactorsUnited Kingdom

Identifiers

PMID31801749
PMCPMC6891802

What OpenQuestion holds

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LicenceCC BY-NC
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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.