Outcomes of Cardiac Arrest in Residential Care Homes for the Elderly in Hong Kong

Fan, Kit Ling; Leung, LP

doi:10.1080/10903127.2017.1317890

Cited by 14 publications

(16 citation statements)

References 16 publications

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“…We found 30-day survival in nursing home residents to be 1.7%, which is substantially higher than 0.3-0.5% found in other studies reporting 30-day survival after OHCA in nursing home facilities [12,20]. In contrast, AED is only useful in case of shockable heart rhythms, which we found to be limited to 7.6% of the nursing home population, and AEDs in nursing homes can be used on employees, visitors and community residents outside nursing homes, because nursing homes have 24/7 accessibility.…”

Section: Best-and Worst-case Scenarios In Relation To Survivalcontrasting

confidence: 70%

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Survival after out-of-hospital cardiac arrest in nursing homes – A nationwide study

et al. 2018

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Section: Best-and Worst-case Scenarios In Relation To Survivalcontrasting

confidence: 70%

“…Older studies report similar survival rates between nursing home residents and persons living in the community [7,17,18]. Recent studies from Osaka, Hong Kong, and Copenhagen report 30-day survival rates from 0.3% to 9% [12,19,20].…”

Section: Discussionmentioning

confidence: 94%

Survival after out-of-hospital cardiac arrest in nursing homes – A nationwide study

et al. 2018

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“…Elderlies living in residential care homes make up a relatively high proportion of all OHCA cases – about 40%. 35 Bystander CPR rate is 28.8% and bystander defibrillation rate is less than 1.3%; both are much lower than the localities where the models are developed. 1 The median response time by emergency medical services to cardiac arrest call is as short as 9 min.…”

Section: Using Ohca Prognostic Prediction Model In Hong Kongmentioning

confidence: 84%

Evaluation of prognostic prediction models for out-of-hospital cardiac arrest

Siu

2020

Hong Kong Journal of Emergency Medicine

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Introduction: Accurate prognostic prediction of out-of-hospital cardiac arrest is challenging but important for the emergency team and patient’s family members. A number of prognostic prediction models specifically designed for out-of-hospital cardiac arrest are developed and validated worldwide. Objective: This narrative review provides an overview of the prognostic prediction models out-of-hospital cardiac arrest patients for use in the emergency department. Discussion: Out-of-hospital cardiac arrest prognostic prediction models are potentially useful in clinical, administrative and research settings. Development and validation of such models require prehospital and hospital predictor and outcome variables which are best in the standardised Utstein Style. Logistic regression analysis is traditionally employed for model development but machine learning is emerging as the new tool. Examples of such models available for use in the emergency department include ROSC After Cardiac Arrest, CaRdiac Arrest Survival Score, Utstein-Based Return of Spontaneous Circulation, Out-of-Hospital Cardiac Arrest, Cardiac Arrest Hospital Prognosis and Cardiac Arrest Survival Score. The usefulness of these models awaits future studies.

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“…The worldwide reported outcome of OHCA in nursing homes is extremely poor with an average 30‐day survival between 1.7% and 2.6% . In Hong Kong, only .07% of patients had a good neurologic outcome at 30 days reported . In Australia, Andrew et al reported complete absence of good 12‐month functional recovery after resuscitation of 2575 patients residing in a nursing home .…”

Section: Discussionmentioning

confidence: 99%

“…8,28,29 In Hong Kong, only .07% of patients had a good neurologic outcome at 30 days reported. 30 In Australia, Andrew et al reported complete absence of good 12-month functional recovery after resuscitation of 2575 patients residing in a nursing home. 29 In this patient cohort, even more than in the general older population, a professional and societal debate based on real-life data around CPR seems warranted.…”

Section: Discussionmentioning

confidence: 99%

Cardiopulmonary Resuscitation in Adults Over 80: Outcome and the Perception of Appropriateness by Clinicians

Druwé

Benoît

Monsieurs

et al. 2019

J American Geriatrics Society

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OBJECTIVES To determine the prevalence of clinician perception of inappropriate cardiopulmonary resuscitation (CPR) regarding the last out‐of‐hospital cardiac arrest (OHCA) encountered in an adult 80 years or older and its relationship to patient outcome. DESIGN Subanalysis of an international multicenter cross‐sectional survey (REAPPROPRIATE). SETTING Out‐of‐hospital CPR attempts registered in Europe, Israel, Japan, and the United States in adults 80 years or older. PARTICIPANTS A total of 611 clinicians of whom 176 (28.8%) were doctors, 123 (20.1%) were nurses, and 312 (51.1%) were emergency medical technicians/paramedics. RESULTS AND MEASUREMENTS The last CPR attempt among patients 80 years or older was perceived as appropriate by 320 (52.4%) of the clinicians; 178 (29.1%) were uncertain about the appropriateness, and 113 (18.5%) perceived the CPR attempt as inappropriate. The survival to hospital discharge for the “appropriate” subgroup was 8 of 265 (3.0%), 1 of 164 (.6%) in the “uncertain” subgroup, and 2 of 107 (1.9%) in the “inappropriate” subgroup (P = .23); 503 of 564 (89.2%) CPR attempts involved non‐shockable rhythms. CPR attempts in nursing homes accounted for 124 of 590 (21.0%) of the patients and were perceived as appropriate by 44 (35.5%) of the clinicians; 45 (36.3%) were uncertain about the appropriateness; and 35 (28.2%) perceived the CPR attempt as inappropriate. The survival to hospital discharge for the nursing home patients was 0 of 107 (0%); 104 of 111 (93.7%) CPR attempts involved non‐shockable rhythms. Overall, 36 of 543 (6.6%) CPR attempts were undertaken despite a known written do not attempt resuscitation decision; 14 of 36 (38.9%) clinicians considered this appropriate, 9 of 36 (25.0%) were uncertain about its appropriateness, and 13 of 36 (36.1%) considered this inappropriate. CONCLUSION Our findings show that despite generally poor outcomes for older patients undergoing CPR, many emergency clinicians do not consider these attempts at resuscitation to be inappropriate. A professional and societal debate is urgently needed to ensure that first we do not harm older patients by futile CPR attempts. J Am Geriatr Soc 68:39–45, 2019

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Outcomes of Cardiac Arrest in Residential Care Homes for the Elderly in Hong Kong

Cited by 14 publications

References 16 publications

Survival after out-of-hospital cardiac arrest in nursing homes – A nationwide study

Survival after out-of-hospital cardiac arrest in nursing homes – A nationwide study

Evaluation of prognostic prediction models for out-of-hospital cardiac arrest

Cardiopulmonary Resuscitation in Adults Over 80: Outcome and the Perception of Appropriateness by Clinicians

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