Influence of age on the survival rate of in-hospital and out-of-hospital resuscitation

Juchems, R; Wahlig, G.; Frese, Werner

doi:10.1016/0300-9572(92)90032-8

Cited by 2 publications

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“…Nevertheless, any correlations between the collapse-to-start of the CPR interval and the recorded points in the coma rating can only be interpreted as loose correlations, but not as predefined parameters of predictive power. Age was not a determinant of favourable/non-favourable outcome in our study, which is in keeping with the findings of other studies as well [15]. Comorbidity is supposed to be the key factor.…”

Section: Discussionsupporting

confidence: 92%

The prognostic significance of coma-rating, duration of anoxia and cardiopulmonary resuscitation in out-of-hospital cardiac arrest

Berek

Schinnerl

Traweger

et al. 1997

Journal of Neurology

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Early determination of outcome after successful prehospital cardiopulmonary resuscitation (CPR) is a common problem with great ethical, economic, social, and legal consequences. We prospectively investigated 112 adult patients who had been resuscitated after out-of-hospital cardiac arrest (CA). The aim of our study was to determine whether coma rating by the mobile intensive care unit (MICU) is a useful tool for outcome prediction. For neurological assessment the Innsbruck Coma Scale (ICS) was used initially and after return of spontaneous circulation (ROSC) or 20-30 min after the start of CPR, before any sedating drugs were given. The duration of anoxia and CPR were determined with the automatically recorded emergency call protocol of the dispatch centre and the protocol of the MICU. For estimation of cerebral outcome at the time of discharge from hospital we used the Glasgow-Pittsburgh Cerebral Performance Categories (CPC). Restoration of spontaneous circulation was achieved in 42 patients (37%), and 15 (13%) were discharged from hospital. The first coma rating performed immediately at the time of arrival on scene had no significant prognostic value for prediction of neurological outcome (P = 0.204) and survival (P = 0.103). The second coma rating (performed after ROSC or 20-30 min after the start of CPR), however, demonstrated a significant correlation with neurological outcome (P = 0.0000) and survival (P = 0.0000), a correlation which was comparable to both duration of anoxia and duration of CPR. In patients with out-of-hospital cardiac arrest prognostic information could be obtained with the ICS as early as 20-30 min after the start of cardiopulmonary resuscitation.

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Section: Discussionsupporting

confidence: 92%

The prognostic significance of coma-rating, duration of anoxia and cardiopulmonary resuscitation in out-of-hospital cardiac arrest

Berek

Schinnerl

Traweger

et al. 1997

Journal of Neurology

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“…27 We also recognised the effect that age has on long term survival. Age, however, must not be an independent predictor of outcome, because age may be associated with a higher incidence of unfavourable pre-arrest health conditions 28. The rate of return of spontaneous circulation increased with bystander CPR.…”

Section: Discussionmentioning

confidence: 99%

Long term outcome after out-of-hospital cardiac arrest with physician staffed emergency medical services: the Utstein style applied to a midsized urban/suburban area

Böttiger

Grabner

Bauer

et al. 1999

Heart

207

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Results-Of 330 000 inhabitants, 755 suffered from cardiac arrest covered by the Heidelberg ALS services. In 512 patients, cardiopulmonary resuscitation had been initiated. Of 338 patients with cardiac aetiology, return of spontaneous circulation was achieved in 164 patients (49%), 48 (14%) were discharged alive, and 40 (12%) were alive one year later; most of these patients showed good neurological outcome. Thus, 4.85 patients with cardiac aetiology were saved by the ALS services and discharged alive per 100 000 inhabitants a year. Ventricular fibrillation or tachycardia was detected in 106 patients (31%), other cardiac rhythms in 40 (12%), and asystole in 192 (57%). Hospital discharge rates (and one year survival) in these subgroups were 34.0% (29.2%), 12.5% (7.5%), and 3.6% (3.1%), respectively. Discharge rates increased if cardiac arrest was witnessed (bystander, 20.0%; BLS/ALS personnel, 21.4%; nonwitnessed arrest, 3.3%; p < 0.01), and if the time period between the alarm and the arrival of the ALS unit was four minutes or less (< 4 minutes, 30.6%; 4-8 minutes, 10.4%; > 8 minutes, 8.1%; p < 0.001). In 69 patients with bystander witnessed cardiac arrest with ventricular fibrillation, the discharge rate was 37.7%; 21 patients were alive after one year. Conclusions-A two tier BLS and physician staVed ALS system is associated with good long term outcome of patients suVering from out-of-hospital cardiac arrest of cardiac aetiology in a midsized urban/suburban area. Further studies, however, are required to assess whether having a physician in the ALS unit is an independent determinant for improved long term outcome. (Heart 1999;82:674-679) Keywords: out-of-hospital cardiac arrest; emergency medical services; long term outcome; Utstein style Patient outcome after out-of-hospital cardiac arrest depends on individual, demographic, sociological, and logistic factors.

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Influence of age on the survival rate of in-hospital and out-of-hospital resuscitation

Cited by 2 publications

References 0 publications

The prognostic significance of coma-rating, duration of anoxia and cardiopulmonary resuscitation in out-of-hospital cardiac arrest

The prognostic significance of coma-rating, duration of anoxia and cardiopulmonary resuscitation in out-of-hospital cardiac arrest

Long term outcome after out-of-hospital cardiac arrest with physician staffed emergency medical services: the Utstein style applied to a midsized urban/suburban area

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