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Article

Predictors of In-Hospital Cardiac Arrest Outcomes: A Single-Center Observational Study

by
Maria Aggou
1,†,
Barbara Fyntanidou
2,†,
Andreas S. Papazoglou
3,*,
Marios G. Bantidos
2,4,
Nikolaos Vasileiadis
5,
Dimitrios Vasilakos
1,
Haralampos Karvounis
6,
Dimitrios V. Moysidis
7,
Athina Nasoufidou
4,
Panagiotis Stachteas
4,
Paschalis Karakasis
4,
Konstantinos Fortounis
8,
Eleni Argyriadou
1,
Efstratios Karagiannidis
2,* and
Vasilios Grosomanidis
1
1
Department of Anesthesiology, AHEPA University Hospital, 54636 Thessaloniki, Greece
2
Department of Emergency Medicine, AHEPA University Hospital, 54636 Thessaloniki, Greece
3
Department of Cardiology, Athens Naval Hospital, 11521 Athens, Greece
4
Second Department of Cardiology, Hippokration General Hospital, 54642 Thessaloniki, Greece
5
Amedes Medizinische Dienstleistungen GmbH, 37081 Göttingen, Germany
6
First Department of Cardiology, AHEPA University Hospital, 54636 Thessaloniki, Greece
7
Medical School, Aristotle University of Thessaloniki, 54124 Thessaloniki, Greece
8
Department of Surgery, Papageorgiou General Hospital, 56429 Thessaloniki, Greece
*
Authors to whom correspondence should be addressed.
†
These authors contributed equally to this work.
J. Clin. Med. 2025, 14(21), 7868; https://doi.org/10.3390/jcm14217868
Submission received: 14 October 2025 / Revised: 29 October 2025 / Accepted: 4 November 2025 / Published: 5 November 2025
(This article belongs to the Special Issue Optimizing Outcomes in Emergency Medicine and Cardiopulmonary Resuscitation)
Versions Notes

Abstract

Background/Objectives: In-hospital cardiac arrest (IHCA) carries high mortality and substantial risk of neurological and functional impairment. Given that contemporary, clinically relevant risk models remain limited, especially within Southern European systems, the aim of this study was to develop a process-aware model for bedside risk stratification. Methods: We retrospectively analyzed a single-center cohort from a prospectively maintained resuscitation registry (AHEPA University General Hospital, Thessaloniki). Adults (≥18 years) with index IHCA in 2017–2019 were included. Utstein-defined variables underwent univariable screening, LASSO selection, and collinearity checks before multivariable logistic regression for in-hospital mortality. We assessed discrimination (AUC) and calibration (Hosmer–Lemeshow). Results: Among 826 IHCAs, 137 survived to discharge and 689 died. Higher mortality was independently associated with longer CPR (aOR = 1.115, 95% CI: 1.080–1.158), older age (aOR = 1.034, 95% CI: 1.014–1.055), and CCU location (aOR = 7.303, 95% CI: 2.557–25.798), while operating room (aOR = 0.029, 95% CI: 0.003–0.252), ICU/HDU (aOR = 0.203, 95% CI: 0.065–0.630), and an initial shockable rhythm (aOR = 0.297, 95% CI: 0.144–0.611) were protective. Longer time to CPR initiation also predicted mortality (aOR = 1.746, 95% CI: 1.001–3.162). Model performance was strong (AUC = 0.897, 95% CI: 0.865–0.928) with good calibration (Hosmer–Lemeshow p = 0.879). Conclusions: A process-aware model integrating patient factors, intra-arrest metrics, and location showed excellent internal performance for predicting IHCA mortality. Findings reaffirm the prognostic importance of age, rhythm, and resuscitation timeliness/intensity and support future work extending prediction to neurological/functional outcomes and testing targeted care bundles in high-risk strata.
Keywords: in-hospital cardiac arrest; resuscitation; risk stratification; logistic regression; Utstein style in-hospital cardiac arrest; resuscitation; risk stratification; logistic regression; Utstein style

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MDPI and ACS Style

Aggou, M.; Fyntanidou, B.; Papazoglou, A.S.; Bantidos, M.G.; Vasileiadis, N.; Vasilakos, D.; Karvounis, H.; Moysidis, D.V.; Nasoufidou, A.; Stachteas, P.; et al. Predictors of In-Hospital Cardiac Arrest Outcomes: A Single-Center Observational Study. J. Clin. Med. 2025, 14, 7868. https://doi.org/10.3390/jcm14217868

AMA Style

Aggou M, Fyntanidou B, Papazoglou AS, Bantidos MG, Vasileiadis N, Vasilakos D, Karvounis H, Moysidis DV, Nasoufidou A, Stachteas P, et al. Predictors of In-Hospital Cardiac Arrest Outcomes: A Single-Center Observational Study. Journal of Clinical Medicine. 2025; 14(21):7868. https://doi.org/10.3390/jcm14217868

Chicago/Turabian Style

Aggou, Maria, Barbara Fyntanidou, Andreas S. Papazoglou, Marios G. Bantidos, Nikolaos Vasileiadis, Dimitrios Vasilakos, Haralampos Karvounis, Dimitrios V. Moysidis, Athina Nasoufidou, Panagiotis Stachteas, and et al. 2025. "Predictors of In-Hospital Cardiac Arrest Outcomes: A Single-Center Observational Study" Journal of Clinical Medicine 14, no. 21: 7868. https://doi.org/10.3390/jcm14217868

APA Style

Aggou, M., Fyntanidou, B., Papazoglou, A. S., Bantidos, M. G., Vasileiadis, N., Vasilakos, D., Karvounis, H., Moysidis, D. V., Nasoufidou, A., Stachteas, P., Karakasis, P., Fortounis, K., Argyriadou, E., Karagiannidis, E., & Grosomanidis, V. (2025). Predictors of In-Hospital Cardiac Arrest Outcomes: A Single-Center Observational Study. Journal of Clinical Medicine, 14(21), 7868. https://doi.org/10.3390/jcm14217868

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