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Objectives Our objective is to develop a prediction tool to predict the death after in-hospital cardiac arrest (IHCA).Design We conducted a retrospective double-centre observational study of IHCA patients from January 2015 to December 2021. Data including prearrest diagnosis, clinical features of the IHCA and laboratory results after admission were collected and analysed. Logistic regression analysis was used for multivariate analyses to identify the risk factors for death. A nomogram was formulated and internally evaluated by the boot validation and the area under the curve (AUC). Performance of the nomogram was further accessed by Kaplan-Meier survival curves for patients who survived the initial IHCA.Setting Intensive care unit, Tongji Hospital, China.Participants Adult patients (≥18 years) with IHCA after admission. Pregnant women, patients with ‘do not resuscitation’ order and patients treated with extracorporeal membrane oxygenation were excluded.Interventions None.Primary and secondary outcome measures The primary outcome was the death after IHCA.Results Patients (n=561) were divided into two groups: non-sustained return of spontaneous circulation (ROSC) group (n=241) and sustained ROSC group (n=320). Significant differences were found in sex (p=0.006), cardiopulmonary resuscitation (CPR) duration (p