Long-term outcome of elderly out-of-hospital cardiac arrest survivors as compared with their younger counterparts and the general population

Bart Hiemstra, Remco Bergman, Anthony R Absalom, Joukje van der Naalt, Pim van der Harst, Ronald de Vos, Wybe Nieuwland, Maarten W Nijsten, Iwan C C van der Horst

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Abstract

Background: Over the past decade, prehospital and in-hospital treatment for out-of-hospital cardiac arrest (OHCA) has improved considerably. There are sparse data on the long-term outcome, especially in elderly patients. We studied whether elderly patients benefit to the same extent compared with younger patients and at long-term follow up as compared with the general population.

Methods: Between 2001 and 2010, data from all patients presented to our hospital after OHCA were recorded. Elderly patients (>= 75 years) were compared with younger patients. Neurological outcome was classified as cerebral performance category (CPC) at hospital discharge and long-term survival was compared with younger patients and predicted survival rates of the general population.

Results: Of the 810 patients admitted after OHCA, a total of 551 patients (68%) achieved return of spontaneous circulation, including 125 (23%) elderly patients with a mean age of 81 +/- 5 years. In-hospital survival was lower in elderly patients compared with younger patients with rates of 33% versus 57% (p <0.001). A CPC of 1 was present in 73% of the elderly patients versus 86% of the younger patients (p = 0.031). In 7.3% of the elderly patients, a CPC >2 was observed versus 2.5% of their younger counterparts (p = 0.103). Elderly patients had a median survival of 6.5 [95% confidence interval (CI) 2.0-7.9] years compared with 7.7 (95% CI 7.5-7.9) years of the general population (p = 0.019).

Conclusions: The survival rate after OHCA in elderly patients is approximately half that of younger patients. Elderly patients who survive to discharge frequently have favorable neurological outcomes and a long-term survival that approximates that of the general population.

Original languageEnglish
Pages (from-to)309-320
Number of pages12
JournalTherapeutic advances in cardiovascular disease
Volume12
Issue number12
Early online date20-Sep-2018
DOIs
Publication statusPublished - Dec-2018

Keywords

  • cardiopulmonary resuscitation
  • cerebral performance
  • elderly
  • long-term mortality
  • out-of-hospital cardiac arrest
  • prognosis
  • PERCUTANEOUS CORONARY INTERVENTION
  • CARDIOPULMONARY-RESUSCITATION
  • THERAPEUTIC HYPOTHERMIA
  • COMATOSE SURVIVORS
  • LIFE
  • AGE
  • CATHETERIZATION
  • RECOVERY
  • ST
  • ASSOCIATION

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