This post hoc BOX substudy analysis identified two early post-resuscitation profiles among 700 patients after out-of-hospital cardiac arrest. Class 2 had greater cardiopulmonary dysfunction, higher filling pressures and noradrenaline requirements, with 365-day mortality of 48% versus 21%. No treatment interactions were detected for mean arterial pressure, oxygenation, or fever-control duration. Mortality discrimination was not superior to time to return of spontaneous circulation alone. Exploratory replication in 152 TTM patients showed 180-day mortality of 38% versus 24% (P=0.057), with less pronounced haemodynamic separation.
Early post-arrest profiles were associated with prognosis but did not outperform time to return of spontaneous circulation alone or identify differential treatment responses. Their added clinical utility remains uncertain.
Study limitation: This was a post hoc analysis; replication used a separately fitted model, and absent treatment interactions do not establish equivalent responses.
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