Does age affect outcomes of out-of-hospital cardiopulmonary resuscitation?

Longstreth, W. T.

doi:10.1001/jama.264.16.2109

Cited by 29 publications

(20 citation statements)

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“…Longstreth et al documented a 10% survival to discharge for all OHCA patients older than 70 and a 24% survival rate for patients with the initial arrest rhythm of VF in this age group. 31 Bonnin et al documented a 7% survival to discharge rate for the same age group, with a 14% survival rate for VF patients. 5 Van Hoeyweghen et al identified no significant difference in survival to discharge in a comparison of different age cohorts, but their definition of long-term survival was consciousness at 14 days after arrest.…”

Section: Discussionmentioning

confidence: 96%

Does Advanced Age Matter in Outcomes after Out‐of‐hospital Cardiac Arrest in Community‐dwelling Adults ?

Swor

Jackson

Tintinalli

et al. 2000

Academic Emergency Medicine

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Abstract. Objective: To assess whether advanced age is an independent predictor of survival to hospital discharge in community-dwelling adult patients who sustained an out-of-hospital cardiac arrest in a suburban county. Methods: A prospective cohort study was conducted in a suburban county emergency medical services system of community-dwelling adults who had an arrest from a presumed cardiac cause and who received out-of-hospital resuscitative efforts from July 1989 to December 1993. The cohorts were defined by grouping ages by decade: 19-39, 40-49, 50-59, 60-69, 70-79, and 80 or more. The variables measured included age, gender, witnessed arrest, response intervals, location of arrest, documented bystander cardiopulmonary resuscitation, and initial rhythms. The primary outcome was survival to hospital discharge. Results are reported using analysis of variance, chi square, and adjusted odds ratios from a logistic regression model. Age group 50-59 served as the reference group for the regression model. Results: Of the 2,608 total presumed cardiac arrests, the overall survival rate to hospital discharge was 7.25%. Patients in age groups 40-49 and 50-59 experienced the best rate of successful resuscitation (10%). Each subsequent decade had a steady decline in successful outcome: 8.1% for ages 60-69; 7.1% for ages 70-79; and 3.3% for age 80ϩ. In a post-hoc analysis, further separation of the older age group revealed a successful outcome in 3.9% of patients ages 80-89 and 1% in patients 90 and older. Patients aged 80 years or more were more likely to arrest at home, were more likely to have an initial bradyasystolic rhythm, yet had a similar rate of resuscitation to hospital admission. In the regression model, age 80 or older was associated with a significantly worse survival to hospital discharge (OR = 0.4, 95% CI = 0.20 to 0.82). Conclusions: There was a twofold decrease in survival following out-of-hospital cardiac arrest to discharge in patients aged 80 or more when compared with the reference group in this suburban county setting. However, resuscitation for community-dwelling elders aged 65-89 is not futile. These data support that out-of-hospital resuscitation of elders up to age 90 years is not associated with a universal dismal outcome.

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Section: Discussionmentioning

confidence: 96%

Does Advanced Age Matter in Outcomes after Out‐of‐hospital Cardiac Arrest in Community‐dwelling Adults ?

Swor

Jackson

Tintinalli

et al. 2000

Academic Emergency Medicine

View full text Add to dashboard Cite

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“…This could have something to do with the fact that the proportion of first-grade first responders who could treat patients with professional CPR increased from 2.2% in 2006 to 4.7% in 2014, which led to more cases where AEDs were applied 24) . In addition, there could be many variables at play such as whether bystanders had witnessed cardiac arrest before, whether they had necessarily discovered a cardiac arrest patient, the underlying disease of a patient and bystanders' quality of performance of chest compressions [11][12][13][14][15] . AHA guidelines suggest swift activation of the emergency response system when there is no breath or reaction from a patient after bystander's discovery and assessment of the patient's consciousness 15) .…”

Section: Discussionmentioning

confidence: 99%

“…Based on these low survival rates, several studies suggested that performing CPR on elderly cardiac arrest patients should cease [6][7][8] . However, other studies found that there was no difference in survival rate after CPR between elderly and nonelderly cardiac arrest patients [9][10][11][12][13][14] . In order to raise the survival rate of cardiac arrest patients, it is necessary to ensure that each goal in the chain of survival is successfully met, including swiftly identifying a cardiac arrest, activating the emergency response system, performing early CPR that emphasizes chest compressions, and applying rapid defibrillation [15][16][17][18] .…”

Section: Introductionmentioning

confidence: 99%

Analysis of the Performance for Bystanders’ Cardiopulmonary Resuscitation in Geriatric and Out-of-Hospital Cardiac Arrested Patients

Bae¹,

Oh²,

Lee³

et al. 2016

Ann Geriatr Med Res

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Background: The purpose of this study was to determine if there were changes in bystanders' chest compression performance and activation of emergency medical services in geriatric and out-of-hospital cardiac patients following the institution of the 2010 International Resuscitation Guidelines and 2008 Good Samaritan Law in South Korea. Methods: This is a retrospective observational study using medical records, and including patient charts and an Utstein Style database in a tertiary hospital. We analyzed the existence of chest compression performance by bystanders, the required time from recognition of cardiac arrest to activation of 119 for emergency medicine services, and the required time from activation of 119 to arrival on the scene from 2005-2014. The data were compared after dividing the years into 2 groups: 2005-2009 and 2010-2014. Results: Of 317 geriatric and out-of-hospital cardiac arrest patients, 261 were eligible for this study. Twelve cases were excluded, and a total of 249 were analyzed. Bystander-initiated chest compression was higher from

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“…Most studies involve a small number of patients, 6,[20][21][22][23][24][25][26][27][28] with a few exceptions, [29][30][31] and outcomes are mainly assessed by clinical judgment [21][22][23]26,27,30,31 and rarely by quantitative measurements. 9,10 When no important methodological differences exist, 9,10 our data suggest that across different studies, survivors after CPR have about the same quality of life, regardless of the conditions un- der which CPR took place.…”

Section: Commentmentioning

confidence: 99%