Outcome of non-traumatic out-of-hospital cardiac arrest in the elderly

Ding K. Chien, Wen H. Chang, Shin H. Tsai, Kuo Song Chang, Chang Chih Chen, Yu Jang Su

研究成果: 雜誌貢獻文章

12 引文 (Scopus)

摘要

Background: Because of changes in lifestyle and the advancement of medical science, human life expectancy in Taiwan is longer than it used to be. Since 1993, we have had an "aging population", i.e., the proportion of the elderly population is greater than 7% of the general population and is increasing over time. However, to our knowledge, no study of the outcomes of out-of-hospital cardiac arrest (OHCA) in the elderly has been performed in Taiwan. This study was, therefore, undertaken to identify both the outcomes of these occurrences and the factors that influenced them. Methods: This was a retrospective study. The characteristics of 299 nontraumatic OHCA patients (elderly/adult ratio, 198:101), who received cardiopulmonary resuscitation upon arrival at the emergency department (ED) between January 1, 2005 and December 31, 2005 were reviewed. The group was split between "elderly patients" aged 65 or over and "adult patients" aged 18 to 64. The outcome measurements included return of spontaneous circulation (ROSC) at the ED, survival to hospital admission, and survival to hospital discharge with full neurologic function. Results: The overall survival rate of patients was 7.4%. Of the 198 elderly patients, 85 (42.9%) had ROSC, 50 (25.3%) survived to admission and 12 (6.1%) survived to hospital discharge. In comparison, of the 101 adult patients, 32 (31.7%) had ROSC, 21 (20.8%) survived to admission and 10 (9.9%) survived to hospital discharge. The differences in outcomes between the two groups were not statistically significant. In the subgroup of patients who had ROSC at the ED, the adult group had a higher rate of survival to hospital discharge than the elderly (31.3% vs. 14.1%; p=0.035); but in multivariate analysis, only the initial ventricular fibrillation/ventricular tachycardia rhythm predicted survival rate (odds ratio, 7.912; p=0.007). The factor that predicted ROSC was witnessed arrest. Factors that predicted hospital discharge included witnessed arrest and shorter duration of resuscitation in the ED. Post-resuscitation neurologic outcomes of the survivors showed no significant difference between the two groups. Conclusion: It is rational and necessary to aggressively resuscitate in cases of cardiac arrest among the elderly, because their age did not significantly decrease their survival rate or worsen their post-resuscitation neurologic outcomes, compared with non-elderly patients. All the elderly survivors studied were witnessed arrest cases, with return of circulation within 20 minutes at the ED.

原文英語
頁(從 - 到)60-66
頁數7
期刊International Journal of Gerontology
2
發行號2
DOIs
出版狀態已發佈 - 六月 2008

指紋

Out-of-Hospital Cardiac Arrest
Hospital Emergency Service
Survival Rate
Resuscitation
Nervous System
Taiwan
Survivors
Population
Survival
Cardiopulmonary Resuscitation
Ventricular Fibrillation
Ventricular Tachycardia
Life Expectancy
Heart Arrest
Life Style
Multivariate Analysis
Retrospective Studies
Odds Ratio
Outcome Assessment (Health Care)

ASJC Scopus subject areas

  • Geriatrics and Gerontology

引用此文

Outcome of non-traumatic out-of-hospital cardiac arrest in the elderly. / Chien, Ding K.; Chang, Wen H.; Tsai, Shin H.; Chang, Kuo Song; Chen, Chang Chih; Su, Yu Jang.

於: International Journal of Gerontology, 卷 2, 編號 2, 06.2008, p. 60-66.

研究成果: 雜誌貢獻文章

Chien, Ding K. ; Chang, Wen H. ; Tsai, Shin H. ; Chang, Kuo Song ; Chen, Chang Chih ; Su, Yu Jang. / Outcome of non-traumatic out-of-hospital cardiac arrest in the elderly. 於: International Journal of Gerontology. 2008 ; 卷 2, 編號 2. 頁 60-66.
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abstract = "Background: Because of changes in lifestyle and the advancement of medical science, human life expectancy in Taiwan is longer than it used to be. Since 1993, we have had an {"}aging population{"}, i.e., the proportion of the elderly population is greater than 7{\%} of the general population and is increasing over time. However, to our knowledge, no study of the outcomes of out-of-hospital cardiac arrest (OHCA) in the elderly has been performed in Taiwan. This study was, therefore, undertaken to identify both the outcomes of these occurrences and the factors that influenced them. Methods: This was a retrospective study. The characteristics of 299 nontraumatic OHCA patients (elderly/adult ratio, 198:101), who received cardiopulmonary resuscitation upon arrival at the emergency department (ED) between January 1, 2005 and December 31, 2005 were reviewed. The group was split between {"}elderly patients{"} aged 65 or over and {"}adult patients{"} aged 18 to 64. The outcome measurements included return of spontaneous circulation (ROSC) at the ED, survival to hospital admission, and survival to hospital discharge with full neurologic function. Results: The overall survival rate of patients was 7.4{\%}. Of the 198 elderly patients, 85 (42.9{\%}) had ROSC, 50 (25.3{\%}) survived to admission and 12 (6.1{\%}) survived to hospital discharge. In comparison, of the 101 adult patients, 32 (31.7{\%}) had ROSC, 21 (20.8{\%}) survived to admission and 10 (9.9{\%}) survived to hospital discharge. The differences in outcomes between the two groups were not statistically significant. In the subgroup of patients who had ROSC at the ED, the adult group had a higher rate of survival to hospital discharge than the elderly (31.3{\%} vs. 14.1{\%}; p=0.035); but in multivariate analysis, only the initial ventricular fibrillation/ventricular tachycardia rhythm predicted survival rate (odds ratio, 7.912; p=0.007). The factor that predicted ROSC was witnessed arrest. Factors that predicted hospital discharge included witnessed arrest and shorter duration of resuscitation in the ED. Post-resuscitation neurologic outcomes of the survivors showed no significant difference between the two groups. Conclusion: It is rational and necessary to aggressively resuscitate in cases of cardiac arrest among the elderly, because their age did not significantly decrease their survival rate or worsen their post-resuscitation neurologic outcomes, compared with non-elderly patients. All the elderly survivors studied were witnessed arrest cases, with return of circulation within 20 minutes at the ED.",
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AU - Chen, Chang Chih

AU - Su, Yu Jang

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N2 - Background: Because of changes in lifestyle and the advancement of medical science, human life expectancy in Taiwan is longer than it used to be. Since 1993, we have had an "aging population", i.e., the proportion of the elderly population is greater than 7% of the general population and is increasing over time. However, to our knowledge, no study of the outcomes of out-of-hospital cardiac arrest (OHCA) in the elderly has been performed in Taiwan. This study was, therefore, undertaken to identify both the outcomes of these occurrences and the factors that influenced them. Methods: This was a retrospective study. The characteristics of 299 nontraumatic OHCA patients (elderly/adult ratio, 198:101), who received cardiopulmonary resuscitation upon arrival at the emergency department (ED) between January 1, 2005 and December 31, 2005 were reviewed. The group was split between "elderly patients" aged 65 or over and "adult patients" aged 18 to 64. The outcome measurements included return of spontaneous circulation (ROSC) at the ED, survival to hospital admission, and survival to hospital discharge with full neurologic function. Results: The overall survival rate of patients was 7.4%. Of the 198 elderly patients, 85 (42.9%) had ROSC, 50 (25.3%) survived to admission and 12 (6.1%) survived to hospital discharge. In comparison, of the 101 adult patients, 32 (31.7%) had ROSC, 21 (20.8%) survived to admission and 10 (9.9%) survived to hospital discharge. The differences in outcomes between the two groups were not statistically significant. In the subgroup of patients who had ROSC at the ED, the adult group had a higher rate of survival to hospital discharge than the elderly (31.3% vs. 14.1%; p=0.035); but in multivariate analysis, only the initial ventricular fibrillation/ventricular tachycardia rhythm predicted survival rate (odds ratio, 7.912; p=0.007). The factor that predicted ROSC was witnessed arrest. Factors that predicted hospital discharge included witnessed arrest and shorter duration of resuscitation in the ED. Post-resuscitation neurologic outcomes of the survivors showed no significant difference between the two groups. Conclusion: It is rational and necessary to aggressively resuscitate in cases of cardiac arrest among the elderly, because their age did not significantly decrease their survival rate or worsen their post-resuscitation neurologic outcomes, compared with non-elderly patients. All the elderly survivors studied were witnessed arrest cases, with return of circulation within 20 minutes at the ED.

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KW - Elderly

KW - Out-of-hospital cardiac arrest

KW - Resuscitation

KW - Survival rate

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