Urine Output and Mortality in Patients Resuscitated from out of Hospital Cardiac Arrest

Dhruv Sarma, Meir Tabi, Alejandro A. Rabinstein, Kianoush Kashani, Jacob C. Jentzer

Research output: Contribution to journalArticlepeer-review


Background: Limited data exist regarding urine output (UO) as a prognostic marker in out-of-hospital-cardiac-arrest (OHCA) survivors undergoing targeted temperature management (TTM). Methods: We included 247 comatose adult patients who underwent TTM after OHCA between 2007 and 2017, excluding patients with end-stage renal disease. Three groups were defined based on mean hourly UO during the first 24 h: Group 1 (<0.5 mL/kg/h, n = 73), Group 2 (0.5−1 mL/kg/h, n = 81) and Group 3 (>1 mL/kg/h, n = 93). Serum creatinine was used to classify acute kidney injury (AKI). The primary and secondary outcomes respectively were in-hospital mortality and favorable neurological outcome at hospital discharge (modified Rankin Scale [mRS]<3). Results: In-hospital mortality decreased incrementally as UO increased (adjusted OR 0.9 per 0.1 mL/kg/h higher; p = 0.002). UO < 0.5 mL/kg/h was strongly associated with higher in-hospital mortality (adjusted OR 4.2 [1.6−10.8], p = 0.003) and less favorable neurological outcomes (adjusted OR 0.4 [0.2−0.8], p = 0.007). Even among patients without AKI, lower UO portended higher mortality (40% vs 15% vs 9% for UO groups 1, 2, and 3 respectively, p < 0.001). Conclusion: Higher UO is incrementally associated with lower in-hospital mortality and better neurological outcomes. Oliguria may be a more sensitive early prognostic marker than creatinine-based AKI after OHCA.

Original languageEnglish (US)
Pages (from-to)544-552
Number of pages9
JournalJournal of Intensive Care Medicine
Issue number6
StatePublished - Jun 2023


  • Out-of-hospital-cardiac-arrest (OHCA)
  • acute kidney injury (AKI)
  • post-arrest care
  • prognostication
  • shock

ASJC Scopus subject areas

  • Critical Care and Intensive Care Medicine


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