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

IF 2.2 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS Therapeutic Advances in Cardiovascular Disease Pub Date : 2018-12-01 Epub Date: 2018-09-20 DOI:10.1177/1753944718792420
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.

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院外心脏骤停老年幸存者的长期预后与年轻幸存者和普通人群的比较。
背景在过去十年中,院外心脏骤停(OHCA)的院前和院内治疗有了显著改善。有关长期疗效的数据很少,尤其是老年患者。我们研究了老年患者与年轻患者相比是否同样受益,以及与普通人群相比,老年患者在长期随访中是否同样受益:2001年至2010年期间,我们记录了所有在我院接受过心脏骤停抢救的患者的数据。老年患者(⩾75岁)与年轻患者进行了比较。出院时的神经功能结果按照脑功能类别(CPC)进行分类,长期存活率与年轻患者和普通人群的预测存活率进行比较:在 810 名 OHCA 患者中,共有 551 名患者(68%)恢复了自主循环,其中包括 125 名老年患者(23%),平均年龄为 81 ± 5 岁。与年轻患者相比,老年患者的院内存活率较低,分别为 33% 和 57% (P < 0.001)。73%的老年患者和86%的年轻患者的CPC为1(P = 0.031)。在 7.3% 的老年患者中观察到 CPC >2,而在年轻患者中仅观察到 2.5% 的 CPC >2(P = 0.103)。老年患者的中位生存期为 6.5 [95% 置信区间 (CI) 2.0-7.9] 年,而普通人群的中位生存期为 7.7 (95% CI 7.5-7.9) 年 ( p = 0.019):结论:老年患者在 OHCA 后的存活率约为年轻患者的一半。结论:老年患者在 OHCA 后的存活率约为年轻患者的一半,存活到出院的老年患者通常具有良好的神经功能,长期存活率接近普通人群。
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来源期刊
Therapeutic Advances in Cardiovascular Disease
Therapeutic Advances in Cardiovascular Disease CARDIAC & CARDIOVASCULAR SYSTEMS-
CiteScore
3.50
自引率
0.00%
发文量
11
审稿时长
9 weeks
期刊介绍: The journal is aimed at clinicians and researchers from the cardiovascular disease field and will be a forum for all views and reviews relating to this discipline.Topics covered will include: ·arteriosclerosis ·cardiomyopathies ·coronary artery disease ·diabetes ·heart failure ·hypertension ·metabolic syndrome ·obesity ·peripheral arterial disease ·stroke ·arrhythmias ·genetics
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