Should the elderly be resuscitated following out-of-hospital cardiac arrest?

Tresch, Donald D.; Thakur, Ranjan K.; Hoffmann, Raymond G.; Olson, David; Brooks, Harold L.

doi:10.1016/0002-9343(89)90259-3

Cited by 91 publications

(32 citation statements)

References 20 publications

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“…Although still favorable, older patients reported lower physical and emotional scores. Previous data regarding QOL following OHCA in the elderly are also inconsistent with variable outcomes (10,(15)(16)(17). Our data add to a study by Tresch et al (17) that found no difference in neurologic outcomes in the elderly population and noted most survivors to be living "fully functional, normal lives" after a mean follow-up of 35 months (17).…”

Section: Discussioncontrasting

confidence: 53%

“…Previous data regarding QOL following OHCA in the elderly are also inconsistent with variable outcomes (10,(15)(16)(17). Our data add to a study by Tresch et al (17) that found no difference in neurologic outcomes in the elderly population and noted most survivors to be living "fully functional, normal lives" after a mean follow-up of 35 months (17). The patients Ͻ65 not only have a favorable long-term survival; their QOL based on the SF-36 scores is indistinguishable from U.S. normative controls.…”

Section: Discussionmentioning

confidence: 99%

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Impact of age on long-term survival and quality of life following out-of-hospital cardiac arrest*

Bunch

White

Khan

et al. 2004

Critical Care Medicine

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The survival rate for ventricular fibrillation out-of-hospital cardiac arrest is significantly improved by the presence of a rapid defibrillation program. In patients <65 yrs old, long-term survival is equal to that of normal individuals and quality of life is similar to the general population. The survival, although high, in older patients is less than that in age-matched healthy controls, and physical and emotional quality of life scores are decreased.

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Section: Discussioncontrasting

confidence: 53%

Section: Discussionmentioning

confidence: 99%

Impact of age on long-term survival and quality of life following out-of-hospital cardiac arrest*

Bunch

White

Khan

et al. 2004

Critical Care Medicine

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“…Key words: age; out-of-hospital cardiac arrest; cardiac arrest; elders; survival; resuscitation; outcomes. ACADEMIC EMERGENCY MEDICINE 2000; 7:762-768 M ANY investigators [1][2][3][4][5][6][7][8][9][10] have studied outcomes after cardiac arrest in elders, with varying results. Some have suggested that resuscitation for elders with cardiac arrest is rarely effective 2,11,12 and that cardiopulmonary resuscitation (CPR) for them may be a curse.…”

mentioning

confidence: 99%

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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“…Pre-arrest and intraarrest factors previously shown to influence survival were included in the multiple logistic regression model (forced entry method) predicting increased mortality following OHCA. The following variables were included: age [3,5,6,[12][13][14][15], sex [16][17][18], comorbidities (cardiac disease [14,18,19], diabetes [15,19], pulmonary and neurologic diseases [20]), functional capacity before cardiac arrest (overall performance category) [5], whether the arrest was witnessed [3,18], bystander-initiated CPR [3,15,18,21], initial rhythm [3,18,22], use of adrenaline [18] and whether the prehospital care was compatible with the guidelines. Concerning the implementation of the guidelines, the patients were divided into three groups: inadequate treatment or monitoring (group 1), treated but treatment goals not achieved (group 2) and care compatible with the guidelines and treatment goals achieved (group 3, reference category).…”

Section: Discussionmentioning

confidence: 99%

Adherence to resuscitation guidelines during prehospital care of cardiac arrest patients

Kirves¹,

Skrifvars

Vähäkuopus

et al. 2007

European Journal of Emergency Medicine

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Should the elderly be resuscitated following out-of-hospital cardiac arrest?

Cited by 91 publications

References 20 publications

Impact of age on long-term survival and quality of life following out-of-hospital cardiac arrest*

Impact of age on long-term survival and quality of life following out-of-hospital cardiac arrest*

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

Adherence to resuscitation guidelines during prehospital care of cardiac arrest patients

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