A retrospective analysis of 508 comatose cardiac-arrest survivors examined factors associated with good neurological outcome, defined as best CPC 1–2 between 3 and 6 months. Good outcome occurred in 38.2%. Age had a nonlinear association with outcome (nonlinearity p=0.020), while shockable rhythm was associated with good outcome (adjusted OR 6.68; 95% CI 4.19–10.66). Discrimination did not differ significantly between spline and linear models (AUC 0.775 versus 0.767; p=0.179). In multiple-imputation analyses, each additional five minutes to ROSC was associated with lower odds of good outcome (OR 0.86; 95% CI 0.77–0.97).
Age’s association with neurological recovery may not be linear, but flexible modelling did not significantly improve discrimination. These observational findings inform prognostic research rather than establish individual prognoses.
Study limitation: Retrospective design limits causal interpretation, and time to ROSC was missing in 51.8%, complicating assessment of this important prognostic factor.
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