Five-year survival of patients after out-of-hospital cardiac arrest depending on age

Pleskot, M; Hazuková, Radka; Střítecká, Hana; Čermáková, Eva

doi:10.1016/j.archger.2010.06.021

Cited by 20 publications

(9 citation statements)

References 31 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…As termination of resuscitation in the field is not permitted in Japan, almost all patients with OHCA are transported to hospital. Accordingly, the mean age of patients transported to the hospital in the present study (mean 73.7 years, standard deviation 16.2) was higher than that in the United States [15] (mean 64.0 years, standard deviation 18.2) and European countries [16,18]. Therefore, the beneficial association of age with neurological outcomes may be reduced in other countries where termination of resuscitation in patients with refractory OHCA [5,6] is applied.…”

Section: Discussionmentioning

confidence: 58%

Neurological outcomes in patients transported to hospital without a prehospital return of spontaneous circulation after cardiac arrest

2013

View full text Add to dashboard Cite

IntroductionAs emergency medical services (EMS) personnel in Japan are not allowed to perform termination of resuscitation in the field, most patients experiencing an out-of-hospital cardiac arrest (OHCA) are transported to hospitals without a prehospital return of spontaneous circulation (ROSC). As the crucial prehospital factors for outcomes are not clear in patients who had an OHCA without a prehospital ROSC, we aimed to determine the prehospital factors associated with 1-month favorable neurological outcomes (Cerebral Performance Category scale 1 or 2 (CPC 1–2)).MethodsWe analyzed the data of 398,121 adult OHCA patients without a prehospital ROSC from a prospectively recorded nationwide Utstein-style Japanese database from 2007 to 2010. The primary endpoint was 1-month CPC 1–2.ResultsThe rate of 1-month CPC 1–2 was 0.49%. Multivariate logistic regression analysis indicated that the independent variables associated with CPC 1–2 were the following nine prehospital factors: (1) initial non-asystole rhythm (ventricular fibrillation (VF): adjusted odds ratio (aOR), 9.37; 95% confidence interval (CI), 7.71 to 11.4; pulseless ventricular tachycardia (VT): aOR, 8.50; 95% CI, 5.36 to 12.9; pulseless electrical activity (PEA): aOR, 2.75; 95% CI, 2.40 to 3.15), (2) age <65 years (aOR, 3.90; 95% CI, 3.28 to 4.67), (3) arrest witnessed by EMS personnel (aOR, 2.82; 95% CI, 2.48 to 3.19), (4) call-to-hospital arrival time <24 minutes (aOR, 2.58; 95% CI, 2.22 to 3.01), (5) arrest witnessed by any layperson, (6) physician-staffed ambulance, (7) call-to-response time <5 minutes, (8) prehospital shock delivery, and (9) presumed cardiac cause. When four crucial key factors (with an aOR >2.0 in the regression model: initial non-asystole rhythm, age <65 years, EMS-witnessed arrest, and call-to-hospital arrival time <24 minutes) were present, the rates of 1-month CPC 1–2 and 1-month survival were 16.1% and 23.2% in initial VF, 8.3% and 16.7% in pulseless VT, and 3.8% and 9.4% in PEA, respectively.ConclusionsIn OHCA patients transported to hospitals without a prehospital ROSC, nine prehospital factors were significantly associated with 1-month CPC 1–2. Of those, four are crucial key factors: initial non-asystole rhythm, age <65 years, EMS-witnessed arrest, and call-to-hospital arrival time <24 minutes.

show abstract

Section: Discussionmentioning

confidence: 58%

Neurological outcomes in patients transported to hospital without a prehospital return of spontaneous circulation after cardiac arrest

2013

View full text Add to dashboard Cite

show abstract

“…All studies were retrospective cohort studies or chart reviews, with the exception of Ghusn [17], which was a case control study. All but one study [38] reported at least survival to discharge; seven reported long term outcomes as well [23,25,27,28,37,38]. …”

Section: Resultsmentioning

confidence: 99%

“…In patients that did not regain and sustain vital signs in the field, only 0.6% survived to discharge neurologically intact [24]. Other studies that included only patients over 70 years showed that although the overall survival was low, the majority of the survivors displayed moderate to good cerebral performance [18,25,28,32,37]. The study of Pleskot et al showed no difference between younger and older survivors in cerebral performance, but the number of survivors was insufficient to identify significant differences [28].…”

Section: Findings Of the Included Studiesmentioning

confidence: 99%

Pre-arrest predictors of survival after resuscitation from out-of-hospital cardiac arrest in the elderly a systematic review

et al. 2013

View full text Add to dashboard Cite

BackgroundTo enable older people to make decisions about the appropriateness of cardiopulmonary resuscitation (CPR), information is needed about the predictive value of pre-arrest factors such as comorbidity, functional and cognitive status on survival and quality of life of survivors. We systematically reviewed the literature to identify pre-arrest predictors for survival, quality of life and functional outcomes after out-of-hospital (OHC) CPR in the elderly.MethodsWe searched MEDLINE (through May 2011) and included studies that described adults aged 70 years and over needing CPR after OHC cardiac arrest. Prognostic factors associated with survival to discharge and quality of life of survivors were extracted. Two authors independently appraised the quality of each of the included studies. When possible a meta-analysis of odd’s ratios was performed.ResultsTwenty-three studies were included (n = 44,582). There was substantial clinical and statistical heterogeneity and reporting was often inadequate. The pooled survival to discharge in patients >70 years was 4.1% (95% CI 3.0-5.6%). Several studies showed that increasing age was significantly associated with worse survival, but the predictive value of comorbidity was investigated in only one study. In another study, nursing home residency was independently associated with decreased chances of survival. Only a few small studies showed that age is negatively associated with a good quality of life of survivors. We were unable to perform a meta-analysis of possible predictors due to a wide variety in reporting and statistical methods.ConclusionsAlthough older patients have a lower chance of survival after CPR in univariate analysis (i.e. 4.1%), older age alone does not seem to be a good criterion for denying patients CPR. Evidence for the predictive value of comorbidities and for the predictive value of age on quality of life of survivors is scarce. Future studies should use uniform methods for reporting data and pre-arrest factors to increase the available evidence about pre arrest factors on the chance of survival. Furthermore, patient-specific outcomes such as quality of life and post-arrest cognitive function should be investigated too.

show abstract

“…15 The previous landmark randomized studies had limited representation of elderly patients, 2,3 while some observational studies did not include patients >73 years. 16,17 Often analysis on survival in elderly after OHCA is limited to hospital discharge or 30-day survival, 18,19 but some observational studies investigate long-term outcome and do not recommend that age should influence treatment decision 20,21 or find that most elderly >65 VF OHCA survivors return to work post-arrest. 22 The increased mortality in the elderly also impacts the assessment of neurological outcome by the CPC and mRS scales, but when focusing on survivors, the elderly had increased risk of poor neurological outcome.…”

Section: Discussionmentioning

confidence: 99%

Mortality and neurological outcome in the elderly after target temperature management for out-of-hospital cardiac arrest

et al. 2015

View full text Add to dashboard Cite

Five-year survival of patients after out-of-hospital cardiac arrest depending on age

Cited by 20 publications

References 31 publications

Neurological outcomes in patients transported to hospital without a prehospital return of spontaneous circulation after cardiac arrest

Neurological outcomes in patients transported to hospital without a prehospital return of spontaneous circulation after cardiac arrest

Pre-arrest predictors of survival after resuscitation from out-of-hospital cardiac arrest in the elderly a systematic review

Mortality and neurological outcome in the elderly after target temperature management for out-of-hospital cardiac arrest

Contact Info

Product

Resources

About