Evidence map›Paper›PMID 42237219›Full record

ArticleBMC cardiovascular disorders2026

Impact of transient return of spontaneous circulation and downtime on neurological outcomes following extracorporeal cardiopulmonary resuscitation for refractory out-of-hospital cardiac arrest: a single-center retrospective study.

Takehiro Homma, Tatsuhiro Shibata, Kenta Murotani, Yoshihisa Matsushima, Kodai Shibao, Kensuke Hori, Maki Otsuka, Osamu Takasu, Yoshihiro Fukumoto

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Article in BMC cardiovascular disorders, 2026. 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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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

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3 · Its place in the literature

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4 · The record

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5 · Who and what money

Authors and funding

9 authors.

Takehiro HommaDivision of Cardiovascular Medicine, Department of Internal Medicine, Kurume University School of Medicine, 67 Asahi-machi, Kurume, Fukuoka, 830-0011, Japan.
Tatsuhiro ShibataDivision of Cardiovascular Medicine, Department of Internal Medicine, Kurume University School of Medicine, 67 Asahi-machi, Kurume, Fukuoka, 830-0011, Japan. shibata_tatsuhiro@kurume-u.ac.jp.
Kenta MurotaniBiostatistics Center, Kurume University, Kurume, Japan.
Yoshihisa MatsushimaDivision of Cardiovascular Medicine, Department of Internal Medicine, Kurume University School of Medicine, 67 Asahi-machi, Kurume, Fukuoka, 830-0011, Japan.
Kodai ShibaoDivision of Cardiovascular Medicine, Department of Internal Medicine, Kurume University School of Medicine, 67 Asahi-machi, Kurume, Fukuoka, 830-0011, Japan.
Kensuke HoriDivision of Cardiovascular Medicine, Department of Internal Medicine, Kurume University School of Medicine, 67 Asahi-machi, Kurume, Fukuoka, 830-0011, Japan.
Maki OtsukaDivision of Cardiovascular Medicine, Department of Internal Medicine, Kurume University School of Medicine, 67 Asahi-machi, Kurume, Fukuoka, 830-0011, Japan.
Osamu TakasuAdvanced Emergency and Critical Care Center, Kurume University Hospital, Kurume, Japan.
Yoshihiro FukumotoDivision of Cardiovascular Medicine, Department of Internal Medicine, Kurume University School of Medicine, 67 Asahi-machi, Kurume, Fukuoka, 830-0011, Japan.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundDespite recent advancements in cardiopulmonary resuscitation (CPR), the prognosis of out-of-hospital cardiac arrest (OHCA) remains poor. Extracorporeal cardiopulmonary resuscitation (ECPR) offers potential benefits to improve outcomes of patients with refractory OHCA. Identifying the factors associated with neurological outcomes at 180 days and their interactions remains critical for optimizing patient selection.

methodsThis single-center retrospective study analyzed consecutive patients with OHCA treated with ECPR at Kurume University Hospital between 2016 and 2023. Factors associated with the neurological outcomes at 180 days were evaluated using logistic regression and decision tree analyses.

resultsA total of 65 patients were included. Favorable neurological outcomes at 180 days were recorded in 18 (27.7%) patients. Transient return of spontaneous circulation (ROSC) (adjusted odds ratio (aOR): 8.37, 95% confidence interval (CI): 2.20-38.79) and shorter downtime (aOR: 0.95, 95% CI: 0.90-0.99) were independently associated with favorable neurological outcomes. Decision tree analysis revealed that the presence of transient ROSC and bystander CPR are upstream factors associated with favorable neurological outcomes, and that the absence of transient ROSC with prolonged downtime was associated with unfavorable outcomes.

conclusionTransient ROSC and shorter downtime were independently associated with favorable neurological outcomes at 180 days in patients treated with ECPR. Using a decision-tree model, we visualized how these key factors interact to influence long-term neurological recovery, highlighting their potential importance in refining the patient selection process for ECPR.

Indexed as

Cardiopulmonary ResuscitationExtracorporeal Membrane OxygenationNervous System DiseasesOut-of-Hospital Cardiac ArrestReturn of Spontaneous CirculationAgedFemaleHumansMaleMiddle AgedRecovery of FunctionRetrospective StudiesRisk AssessmentRisk FactorsTime FactorsTreatment OutcomeDowntimeextracorporeal cardiopulmonary resuscitationExtracorporeal membrane oxygenationNeurological outcomeOut-of-hospital cardiac arrestRefractory cardiac arrestTransient return of spontaneous circulation

Identifiers

PMID42237219
PMCPMC13455402

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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.