Survival after out-of-hospital cardiac arrest in elderly patients

• Published in: Annals of emergency medicine Vol. 21; no. 10; pp. 1179 - 1184
• Main Authors: Van Hoeyweghen, Raf J, Bossaert, Leo L, Mullie, Arsene, Martens, Patrick, Delooz, Herman H, Buylaert, Walter A, Calle, Paul A, Come, Luc
• Format: Journal Article
• Language: English
• Published: New York, NY Mosby, Inc 01.10.1992; Elsevier
• Subjects: Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy; Biological and medical sciences; cardiac arrest; CPR do-not-resuscitate orders; Emergency and intensive cardiocirculatory care. Cardiogenic shock. Coronary intensive care; Intensive care medicine; Medical sciences; CPR do-not-resuscitate orders; cardiac arrest; Human; Intensive cardiocirculatory care; Cardiocirculatory arrest; Prognosis; Cardiovascular disease; Survival; Elderly; Age
• ISSN: 0196-0644; 1097-6760
• DOI: 10.1016/S0196-0644(05)81742-1

To study whether age of the cardiac arrest patient is related to prognostic factors and survival. Retrospective analysis of a prospective registration of cardiac arrest events in the mobile ICUs of seven participating hospitals. Two thousand seven hundred seventy-six out-of-hospital cardiac arrests in which advanced life support was initiated. Cardiac arrests with a precipitating event requiring specific therapeutic consequences and with specific prognosis were not included in the analysis (eg, trauma, exsanguination, drowning, sudden infant death syndrome). Neither resuscitation rate (23%) nor mortality caused by a neurologic reason (9%) was significantly different between age groups. Mortality after CPR of non-neurologic etiology was significantly higher in the elderly patient (younger than 40 years, 16%; 40 to 69 years, 19%; 70 to 79 years, 30%; 80 years or older, 34%; P < .005) and had a negative effect on survival in resuscitated elderly patients ( P < .05). Elderly patients more frequently had a dependent lifestyle before the arrest ( P < .025), an arrest of cardiac origin ( P < .001), electromechanical dissociation as the type of cardiac arrest ( P < .025), and a shorter duration of advanced life support in unsuccessful resuscitation attempts ( r = −.178, P < .0001). Because survival two weeks after CPR was not significantly different between age groups, we suggest that decision making in CPR should not be based on age but on factors with better predictive power for outcome and quality of survival.