Epidemiology of hypoxic-ischemic encephalopathy after cardiopulmonary resuscitation in intensive care units: a nationwide database study in China

The high mortality rate associated with cardiac arrest poses a significant clinical challenge. Hypoxic-ischemic encephalopathy (HIE) following successful cardiopulmonary resuscitation (CPR) is the principal determinant of patient outcomes after cardiac arrest. However, the epidemiological profile of patients with HIE in intensive care units (ICUs) remains poorly defined.

We performed a comprehensive analysis of clinical data from 44,535 patients with HIE following CPR, derived from inpatient medical record front sheets collected between 2020 and 2021 across 31 provinces in China.

Patients with HIE after CPR accounted for 1.41% of all ICU admissions. The ICU mortality rate among these patients was 60.65%. Notable regional variations in both incidence and mortality rates were observed across China, which was associated with regional economic level. Mortality was significantly higher among patients with multiple comorbidities, complications, use of invasive interventions, delayed tracheotomy, and blood transfusion.

This study published online in the Journal of Intensive Medicine on July 19, 2026, provides a detailed nationwide epidemiological assessment of HIE following CPR in China. The differences in the incidence and mortality rate among provinces require more attention, underscoring the need to implement standardized clinical protocols, strengthen quality control, and enhance the homogeneity of treatment for these patients.

Reference
Title of original paper: Epidemiology of hypoxic-ischemic encephalopathy after cardiopulmonary resuscitation in intensive care units: A nationwide database study in China
Journal: Journal of Intensive Medicine
DOI: https://doi.org/10.1016/j.jointm.2026.07.001

About Central South University, China
Central South University is a major public research university located in Changsha, Hunan Province, China, directly administered by the country's Ministry of Education. It was formed in April 2000 by merging the former Hunan Medical University, Changsha Railway Institute, and Central South University of Technology. It is one of the first key universities under the national "211 Project.” It is a key high-level university jointly built by the national "985 Project" by the ministry and province, and one of the first leading universities under the national "2011 Plan."
Website: https://www.csu.edu.cn/

About Dr. Xiang Zhou from Peking Union Medical College Hospital, China
Dr. Xiang Zhou is affiliated with the Department of Critical Care Medicine, Peking Union Medical College Hospital, China. He is the Director of the Information Department at Peking Union Medical College Hospital and the National Intensive Care Medicine Quality Control Center. He has received fifty medical awards for leading multiple national key R&D projects and provincial/ministerial-level research initiatives. These include one first-class provincial/ministerial-level scientific research achievement award, five second-class awards, and one third-class award. He has published over 180 papers in domestic and international academic journals, with two first-class awards at the National Intensive Care Medicine Academic Conference.

About Dr. Lina Zhang from Central South University, China
Dr. Lina Zhang is affiliated with the Department of Critical Care Medicine, Central South University, China. She is the Director of the Intensive Care Medicine Center at Xiangya Hospital, Central South University; Vice President of the Intensive Care Physicians Branch of the Chinese Medical Association; Standing Committee Member of the Intensive Care Medicine Branch, Chinese Medical Association; Member of the National Critical Care Medicine Quality Control Center and Head of the Critical Care Neurology Subgroup; Director of the Intensive Care Medicine Quality Control Center in Hunan Province; and Director of the Intensive Medicine Branch of the Hunan Medical Association. She has published over 100 papers in domestic and international academic journals.

Funding information
This work was supported by the National Key Research and Development Program of China [Grant No. 2024YFF1207100]; the National Outstanding Young Medical Talents Program; Hunan Provincial Science and Technology Innovation Leading Talent Program [Grant No. 2023RC1030]; the Central South University Sublimation Scholars Program (2024); the National Natural Science Foundation of China [Grant No. 82372199]; the Natural Science Foundation of Hunan Province [Grant Nos. 2025JJ40070, 2024JJ5559].