ArticleAnnals of intensive care2023
Factors associated with circulatory death after out-of-hospital cardiac arrest: a population-based cluster analysis.
Article in Annals of intensive care, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers, 1 of them a synthesis that pooled it.
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Who cites it
7 citing papers in PubMed, 1 synthesis or guideline pooled it, 13 citations in OpenAlex.
- Unsupervised Clustering in Neurocritical Care: A Systematic Review.Neurocritical care · 2025Pooled it
- Management of post-resuscitation vasoplegic shock: targets, strategies and outcomes.Critical care (London, England) · 2025Review
- Hydrocortisone and arginine vasopressin in post-resuscitation shock: the HYVAPRESS trial.Resuscitation plus · 2025Article
- Metabolic effects of high-dose glucocorticoid following out-of-hospital cardiac arrest.Intensive care medicine experimental · 2025Article
- Fluid balance and outcome in cardiac arrest patients admitted to intensive care unit.Critical care (London, England) · 2025Observational
- Optimizing brain protection after cardiac arrest: advanced strategies and best practices.Interface focus · 2024Review
- Cumulative dose of epinephrine and mode of death after non-shockable out-of-hospital cardiac arrest: a registry-based study.Critical care (London, England) · 2023Article
Corrections and comments
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Authors and funding
12 authors at 5 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundOut-of-hospital cardiac arrest (OHCA) is a common cause of death. Early circulatory failure is the most common reason for death within the first 48 h. This study in intensive care unit (ICU) patients with OHCA was designed to identify and characterize clusters based on clinical features and to determine the frequency of death from refractory postresuscitation shock (RPRS) in each cluster.
methodsWe retrospectively identified adults admitted alive to ICUs after OHCA in 2011-2018 and recorded in a prospective registry for the Paris region (France). We identified patient clusters by performing an unsupervised hierarchical cluster analysis (without mode of death among the variables) based on Utstein clinical and laboratory variables. For each cluster, we estimated the hazard ratio (HRs) for RPRS.
resultsOf the 4445 included patients, 1468 (33%) were discharged alive from the ICU and 2977 (67%) died in the ICU. We identified four clusters: initial shockable rhythm with short low-flow time (cluster 1), initial non-shockable rhythm with usual absence of ST-segment elevation (cluster 2), initial non-shockable rhythm with long no-flow time (cluster 3), and long low-flow time with high epinephrine dose (cluster 4). RPRS was significantly associated with this last cluster (HR, 5.51; 95% confidence interval 4.51-6.74).
conclusionsWe identified patient clusters based on Utstein criteria, and one cluster was strongly associated with RPRS. This result may help to make decisions about using specific treatments after OHCA.
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