BACKGROUND: An increasing proportion of patients who have an out-of-hospital cardiac arrest are initially successfully resuscitated and thus hospitalized. AIMS: To define risk indicators for, and to describe the mode of, in-hospital death among patients hospitalized after an out-of-hospital cardiac arrest. SETTING: Göteborg, Sweden. PATIENTS: All patients hospitalized after out-of-hospital cardiac arrest between 1980 and 1992. RESULTS: A total of 707 out of 3434 patients were hospitalized after out-of-hospital cardiac arrest, of whom 278 (39%) were discharged alive. Independent risk indicators for in-hospital death were: type of initial arrhythmia on the scene, age, interval between cardiac arrest and arrival of first ambulance, bystander-initiated cardiopulmonary resuscitation and history of diabetes mellitus. Of the patients who died in hospital, 88% had brain damage and 43% myocardial damage. CONCLUSION: Risk indicators for hospital death can be defined. The majority of in-hospital deaths were associated with brain damage.