Prognosis

• previous disease: ^b  
  • stroke ^a
  • renal failure ^{a b}
  • cancer (particularly if metastatic) ^b
  • diabetes ^b
• current illness 
  • congestive heart failure ^{a b}
  • sepsis ^b
  • pneumonia ^b
• old age ^a or a poor functional status ^b
• fine ventricular fibrillation on admission ECG ^b
• prolonged arrest or resuscitation attempt ^b
• coma following the arrest ^c

Why?

• 4.2% of patients in a coma post-arrest survive one month (95% CI: 1.8% to 6.6%) ^c

Previous and current illness, old age and prolonged resuscitation increase the risk of dying

Patient	Prognostic Factor	Outcome	CER	OR (95% CI)	NNF+ (95% CI)
post-cardiac arrest a	stroke before admission independent	survival at discharge	23%	0.3 (0.1 to 0.7)	7 (5 to 17)
	renal failure before admission independent	survival at discharge	23%	0.3 (0.1 to 0.8)	7 (5 to 27)
post-cardiac arrest b	cancer independent	death at discharge	84%	3.08 (1.82 to 5.20)	10 (8 to 15)
	metastatic cancer independent	death at discharge	86%	44.9 (9.53 to 212)	8 (7 to 8)
post-cardiac arrest b	diabetes independent	death at 6 months	81%	1.38 (1.12 to 1.70)	15 (8 to 46)
post-cardiac arrest a	congestive heart failure during admission independent	survival at discharge	23%	0.4 (0.2 to 0.9)	8 (6 to 56)
post-cardiac arrest b	sepsis independent	death at discharge	85%	6.86 (2.51 to 18.8)	8 (7 to 12)
	pneumonia independent	death at discharge	83%	2.86 (1.43 to 5.72)	9 (7 to 22)
post-cardiac arrest a	aged 70 or more independent	survival at discharge	25%	0.6 (0.4 to 0.9)	13 (8 to 56)
post-cardiac arrest b	dependent functional status independent	death at discharge	81%	4.99 (2.92 to 8.55)	7 (6 to 8)
post-cardiac arrest b	total arrest time > 5 minutes independent	death at 6 months	81%	1.74 (1.47 to 2.06)	3 (2 to 5)
	resuscitation time > 20 minutes independent	death at 6 months	81%	1.36 (1.12 to 1.64)	9 (5 to 26)

Fine VF increases the risk of dying

Patient	Prognostic Factor	Outcome	CER	RR (95% CI)	NNF+ (95% CI)
out-of-hospital cardiac arrest b	fine VF independent	death at discharge	31%	1.46 (1.32 to 1.62)	3 (3 to 5)