Patients who survived discharge after a second OHCA represented a rare and clinically vulnerable postarrest population with poor subsequent 5-year survival (95% mortality) and greater life-sustaining device dependence compared to single OHCA survivors (47.3% mortality).
Five-year mortality was substantially higher among 2-OHCA survivors than among 1-OHCA survivors.
Among 239,929 OHCA cases identified in the nationwide database, only 15,617 survived to hospital discharge.
Second OHCA survivors were characterized by lower rates of device-free status and higher rates of triple-device use compared to first OHCA survivors.
In 1-OHCA survivors, mortality increased with age, male sex, and nasogastric tube use.
In 1-OHCA survivors, more than 3 outpatient visits, Foley catheter use, and tracheostomy or ventilation were associated with lower observed postdischarge mortality.
Survivors of a second OHCA represent a rare population, constituting only 201 of 15,617 total OHCA survivors who reached hospital discharge.
This research used Taiwan's national health insurance database to study what happens to people who survive cardiac arrests that occur outside of a hospital. The study compared two groups: people who survived one out-of-hospital cardiac arrest (OHCA) and were later discharged from the hospital, versus the rare group who survived two separate out-of-hospital cardiac arrests and were discharged after both. Out of nearly 230,000 cardiac arrest cases over a decade, only about 15,600 people survived to leave the hospital, and just 201 of those had survived two separate cardiac arrests. The study found that people who survived a second cardiac arrest had dramatically worse long-term outcomes: 95% of them died within 5 years of their second hospital discharge, compared to about 47% of single cardiac arrest survivors. Second-time survivors also relied more heavily on life-sustaining medical devices such as feeding tubes, catheters, and ventilators, suggesting they required more intensive ongoing care. Among single arrest survivors, being older, male, or requiring a nasogastric feeding tube was linked to higher mortality, while having more outpatient follow-up visits and certain device use were associated with lower mortality — though the researchers caution these device associations reflect care intensity and patient condition rather than the devices themselves extending life. This research suggests that people who survive a second out-of-hospital cardiac arrest are an exceptionally vulnerable group who face very high risk of death and significant care needs in the years that follow. The authors emphasize that findings are descriptive and should not be interpreted as causal, but that population-level health data like insurance records can help identify and track these rare, high-risk survivors. This information could be useful for healthcare planning, helping clinicians and families understand the serious prognosis associated with surviving a second cardiac arrest and the likely need for ongoing medical support.
Lin C, Fan C, Huang E, Sung C. (2026). Long-Term Survival and Life-Sustaining Device Use in Survivors of First and Second Out-of-Hospital Cardiac Arrest: Retrospective Cohort Study.. JMIR public health and surveillance. https://doi.org/10.2196/90416