{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,12,4]],"date-time":"2025-12-04T18:46:00Z","timestamp":1764873960482,"version":"3.40.5"},"reference-count":40,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2022,3,29]],"date-time":"2022-03-29T00:00:00Z","timestamp":1648512000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100001350","name":"Ministry of Health -Singapore","doi-asserted-by":"publisher","award":["HSRG\/0021\/2012"],"award-info":[{"award-number":["HSRG\/0021\/2012"]}],"id":[{"id":"10.13039\/501100001350","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100001349","name":"National Medical Research Council","doi-asserted-by":"publisher","award":["NMRC\/CSA\/024\/2010"],"award-info":[{"award-number":["NMRC\/CSA\/024\/2010"]}],"id":[{"id":"10.13039\/501100001349","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Journal of Arrhythmia"],"published-print":{"date-parts":[[2022,6]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Sudden cardiac arrest with or without sudden cardiac death (SCD) represents a heterogeneous spectrum of underlying etiology but is often a catastrophic event. Despite improvements in pre\u2010hospital response and post\u2010resuscitation care, outcomes remain grim. Thus, we aim to evaluate the predictors of survival in out\u2010of\u2010hospital cardiac arrests (OHCAs) and describe autopsy findings of those with the uncertain cause of death (COD).<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>This is a subgroup analysis of the Singapore cohort from the Pan Asian Resuscitation Outcome Study which studied 933 OHCAs admitted to two Singapore tertiary hospitals from April 2010 to May 2012.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Of the patients analysed, 30.2% (<jats:italic>n<\/jats:italic>\u00a0=\u00a0282) had an initial return of spontaneous circulation (ROSC) at the emergency department, 18.0% (<jats:italic>n<\/jats:italic>\u00a0=\u00a0168) had sustained ROSC with subsequent admission and 3.4% (<jats:italic>n<\/jats:italic>\u00a0=\u00a032) had survival to discharge. On multivariate analysis, an initial shockable rhythm, a witnessed event, prehospital defibrillation, and shorter time to hospital predicted ROSC as well as survival to discharge. A total of 163 (17.5%) autopsies were performed of which a cardiac etiology of SCD was noted in 92.1% (<jats:italic>n<\/jats:italic>\u00a0=\u00a0151). Ischemic heart disease accounted for 54.3% (<jats:italic>n<\/jats:italic>\u00a0=\u00a089) of the autopsy cohort, with acute myocardial infarction (26.9%, <jats:italic>n<\/jats:italic>\u00a0=\u00a044) and myocarditis (3.7%, <jats:italic>n<\/jats:italic>\u00a0=\u00a06) rounding out the top three causes of demise.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>OHCA remains a clinical presentation that portends a poor prognosis. Of those with uncertain COD, cardiac etiology appears to predominate from autopsy study. Identification of prognostic factors will play an important role in improving individual\u2010level and systemic\u2010level variables to further optimize outcomes.<\/jats:p><\/jats:sec>","DOI":"10.1002\/joa3.12705","type":"journal-article","created":{"date-parts":[[2022,3,29]],"date-time":"2022-03-29T10:09:55Z","timestamp":1648548595000},"page":"416-424","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Clinicopathological correlates of out\u2010of\u2010hospital cardiac arrests"],"prefix":"10.1002","volume":"38","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1234-1334","authenticated-orcid":false,"given":"Tony","family":"Li","sequence":"first","affiliation":[{"name":"Department of Cardiology National University Heart Center, Singapore  Singapore Singapore"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jonathan","family":"Yap","sequence":"additional","affiliation":[{"name":"Department of 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