Key result
Post-ROSC LVFS independently predicts neurological outcomes in IHCA beyond CASPRI and MEWS risk scores.
Why the study?
In-hospital cardiac arrest is associated with poor neurological recovery partly due to myocardial dysfunction, and the prognostic value of early post-resuscitation LVFS is unclear.
Does early post-resuscitation left ventricular fractional shortening improve prediction of neurological outcome in in-hospital cardiac arrest patients?
Cohort (n=173)
No
Does early post-resuscitation left ventricular fractional shortening improve prediction of neurological outcome in in-hospital cardiac arrest patients?
Odds Ratio: 1.154 (95% CI 1.056–1.262)
p-value: p=0.002
Early bedside echocardiographic assessment of left ventricular fractional shortening provides significant incremental predictive value for neurological recovery after in-hospital cardiac arrest.
Supports early post-ROSC LVFS to refine neurological prognostication in IHCA; extends CASPRI and MEWS but requires prospective validation.
BACKGROUND: In-hospital cardiac arrest (IHCA) is associated with poor neurological recovery, partly driven by post-cardiac arrest syndrome (PCAS) involving myocardial dysfunction. OBJECTIVES: We investigated the prognostic value of early post-resuscitation left ventricular fractional shortening (LVFS) for neurological outcome and its incremental predictive value beyond established clinical risk scores. METHODS: This retrospective cohort study analyzed IHCA patients who achieved ROSC at Zigong Fourth People's Hospital between January 2019 and December 2024. Neurological outcome at discharge was defined by cerebral performance category (CPC) score ≤ 2. Candidate variables were Nassessed using multivariable logistic regression, with nonlinear relationships examined through restricted cubic spline analysis. Model discrimination and improvement were assessed by receiver operating characteristic (ROC) analysis, net reclassification improvement (NRI), integrated discrimination improvement (IDI), and decision curve analysis (DCA). Predefined subgroup analyses were also performed. RESULTS: Among 173 patients, 29 (16.7%) achieved favorable outcomes. Left ventricular fractional shortening (LVFS) was an independent predictor of good neurological recovery (OR 1.154, 95% CI 1.056-1.262, p = 0.002), showing a linear relationship (p for nonlinearity = 0.521). The optimal LVFS cutoff was 29.5% (AUC 0.714). Combined models demonstrated progressive improvement in prediction: LVFS + CASPRI or LVFS + MEWS increased discrimination, and triple integration (LVFS + CASPRI + MEWS) achieved excellent accuracy (AUC 0.904). NRI and IDI of triple integration confirmed reclassification gains (p < 0.05), while DCA showed the highest net clinical benefit. A potential interaction between age and LVFS regarding neurological outcome was observed (p = 0.037). CONCLUSION: LVFS assessed after ROSC independently predicts neurological outcome in IHCA and provides significant incremental predictive value beyond CASPRI and MEWS.
No takes yet. Share an insight, caveat, or question.
Zhong et al. (2026) conducted a cohort in In-hospital cardiac arrest (IHCA) (n=173). Left ventricular fractional shortening (LVFS) was evaluated on Neurological outcome at discharge (cerebral performance category score ≤ 2) (OR 1.154, 95% CI 1.056-1.262, p=0.002). Early post-resuscitation left ventricular fractional shortening independently predicted good neurological recovery in in-hospital cardiac arrest patients (OR 1.154; 95% CI 1.056-1.262; p=0.002).
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: