Evidence map›Paper›PMID 40383503›Full record

ArticleResuscitation2025

Neurologic etiologies of cardiac arrest are associated with early withdrawal of life-sustaining therapy.

Laura Faiver, Jonathan Tam, Patrick J Coppler, Cecelia R Ratay, Nicholas Case, Jonathan Elmer, Pittsburgh Post Cardiac Arrest Service Investigators

Abstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Resuscitation, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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0citing papers in PubMed
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1 · What the graph read from it

What it found

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2 · The registry

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3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

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4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

7 authors.

Laura FaiverDepartment of Critical Care Medicine, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA. Electronic address: Faiverlk@upmc.edu.
Jonathan TamDepartment of Critical Care Medicine, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA.
Patrick J CopplerDepartment of Emergency Medicine, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA.
Cecelia R RatayDepartment of Emergency Medicine, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA.
Nicholas CaseDepartment of Emergency Medicine, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA.
Jonathan ElmerDepartment of Critical Care Medicine, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA; Department of Emergency Medicine, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA; Department of Neurology, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA.
Pittsburgh Post Cardiac Arrest Service Investigators

Funding

NRSA Training CoreTL1TR001858 · NCATS · UNIVERSITY OF PITTSBURGH AT PITTSBURGH · PI RADOMSKI, THOMAS, RUBIO, DORIS M · 2016 to 2025
$11.1M
PREcision Care In Cardiac ArrEst - ICECAP (PRECICECAP)R01NS119825 · NINDS · STANFORD UNIVERSITY · PI ELMER, JONATHAN, HIRSCH, KAREN G · 2021 to 2025
$7.0M
Multidisciplinary Training in Critical Care Outcomes ResearchT32HL007820 · NHLBI · UNIVERSITY OF PITTSBURGH AT PITTSBURGH · PI Timothy D Girard, Jeremy M Kahn · 1996 to 2026
$6.4M
Optimizing Recovery prediction after Cardiac Arrest (ORCA)R01NS124642 · NINDS · UNIVERSITY OF PITTSBURGH AT PITTSBURGH · PI Jonathan Elmer · 2022 to 2026
$3.2M
Emergency Medicine Research TrainingT32HL134615 · NHLBI · UNIVERSITY OF PITTSBURGH AT PITTSBURGH · PI Clifton W. Callaway, DONALD M YEALY · 2017 to 2026
$2.4M
NCATS NIH HHS TL1 TR001858NHLBI NIH HHS T32 HL007820NHLBI NIH HHS T32 HL134615NINDS NIH HHS R01 NS119825NINDS NIH HHS R01 NS124642
6 · The paper itself

Abstract

backgroundNeurologic etiologies of cardiac arrest are uncommon and understudied. We described the characteristics of patients who arrested from neurologic etiologies and tested the hypotheses that survival, rate of withdrawal of life-sustaining therapy for perceived poor neurologic prognosis (WLST-N), and early (≤1 day from arrest) WLST-N would differ between those who did and did not arrest from neurologic etiologies.

methodsWe conducted a retrospective study of patients resuscitated from cardiac arrest. We described the cohort who arrest from neurologic causes. We assessed survival between patients with and without neurologic arrest etiologies using multivariable logistic regression. We used Fisher's exact test to compare proportion of patients with early WLST-N by arrest etiology. We performed a time-to-event analysis and used Cox regression to test the association between arrest etiology and rate of WLST-N, censoring for death from other cause and survival at hospital discharge.

resultsWe included 4,414 patients, of whom 158 (3.6%) arrested from neurologic causes. Compared to patients to non-neurologic arrest etiologies, patients who arrested from neurologic etiologies had lower odds of survival (OR 0.39; 95% CI, 0.21-0.70) and worse functional outcomes (p < 0.001). Patients with neurologic arrest etiologies had increased hazard of WLST-N (HR 2.4; 95% CI, 1.87-3.15) and a greater proportion had early WLST-N (p < 0.001).

conclusionNeurologic etiologies of cardiac were associated with worse functional outcomes and increased in-hospital mortality. Early mortality among patients with neurologic arrest etiologies was driven by withdrawal of life-sustaining treatment for perceived poor neurologic prognosis, suggesting prognostic nihilism.

Indexed as

Cardiopulmonary ResuscitationHeart ArrestLife Support CareNervous System DiseasesWithholding TreatmentAgedFemaleHumansMaleMiddle AgedPrognosisRetrospective StudiesTime FactorsBrain injuryCardiac arrest causesOutcomeWithdrawal of life-sustaining therapy

Identifiers

PMID40383503
PMCPMC12530063

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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.