Survival After Out-of-Hospital Cardiac Arrest in Relation to Age and Early Identification of Patients With Minimal Chance of Long-Term Survival

TY - JOUR

T1 - Survival After Out-of-Hospital Cardiac Arrest in Relation to Age and Early Identification of Patients With Minimal Chance of Long-Term Survival

AU - Wissenberg, Mads

AU - Folke, Fredrik

AU - Hansen, Carolina Malta

AU - Lippert, Freddy K

AU - Kragholm, Kristian

AU - Risgaard, Bjarke

AU - Rajan, Shahzleen

AU - Karlsson, Lena

AU - Søndergaard, Kathrine Bach

AU - Hansen, Steen M

AU - Mortensen, Rikke Normark

AU - Weeke, Peter

AU - Christensen, Erika Frischknecht

AU - Nielsen, Søren L

AU - Gislason, Gunnar H

AU - Køber, Lars

AU - Torp-Pedersen, Christian

N1 - © 2015 American Heart Association, Inc.

PY - 2015/5/5

Y1 - 2015/5/5

N2 - Background - Survival after out-of-hospital cardiac arrest has increased during the last decade in Denmark. We aimed to study the impact of age on changes in survival and whether it was possible to identify patients with minimal chance of 30-day survival. Methods and Results - Using data from the nationwide Danish Cardiac Arrest Registry (2001 -2011), we identified 21 480 patients ≥18 years old with a presumed cardiac-caused out-of-hospital cardiac arrest for which resuscitation was attempted. Patients were divided into 3 preselected age-groups: working-age patients 18 to 65 years of age (33.7%), early senior patients 66 to 80 years of age (41.5%), and late senior patients >80 years of age (24.8%). Characteristics in working-age patients, early senior patients, and late senior patients were as follows: witnessed arrest in 53.8%, 51.1%, and 52.1%; bystander cardiopulmonary resuscitation in 44.7%, 30.3%, and 23.4%; and prehospital shock from a defibrillator in 54.7%, 45.0%, and 33.8% (all P<0.05). Between 2001 and 2011, return of spontaneous circulation on hospital arrival increased: working-age patients, from 12.1% to 34.6%; early senior patients, from 6.4% to 21.5%; and late senior patients, from 4.0% to 15.0% (all P<0.001). Furthermore, 30-day survival increased: working-age patients, 5.8% to 22.0% (P<0.001); and early senior patients, 2.7% to 8.4% (P<0.001), whereas late senior patients experienced only a minor increase (1.5% to 2.0%; P=0.01). Overall, 3 of 9499 patients achieved 30-day survival if they met 2 criteria: had not achieved return of spontaneous circulation on hospital arrival and had not received a prehospital shock from a defibrillator. Conclusions - All age groups experienced a large temporal increase in survival on hospital arrival, but the increase in 30-day survival was most prominent in the young. With the use of only 2 criteria, it was possible to identify patients with a minimal chance of 30-day survival.

AB - Background - Survival after out-of-hospital cardiac arrest has increased during the last decade in Denmark. We aimed to study the impact of age on changes in survival and whether it was possible to identify patients with minimal chance of 30-day survival. Methods and Results - Using data from the nationwide Danish Cardiac Arrest Registry (2001 -2011), we identified 21 480 patients ≥18 years old with a presumed cardiac-caused out-of-hospital cardiac arrest for which resuscitation was attempted. Patients were divided into 3 preselected age-groups: working-age patients 18 to 65 years of age (33.7%), early senior patients 66 to 80 years of age (41.5%), and late senior patients >80 years of age (24.8%). Characteristics in working-age patients, early senior patients, and late senior patients were as follows: witnessed arrest in 53.8%, 51.1%, and 52.1%; bystander cardiopulmonary resuscitation in 44.7%, 30.3%, and 23.4%; and prehospital shock from a defibrillator in 54.7%, 45.0%, and 33.8% (all P<0.05). Between 2001 and 2011, return of spontaneous circulation on hospital arrival increased: working-age patients, from 12.1% to 34.6%; early senior patients, from 6.4% to 21.5%; and late senior patients, from 4.0% to 15.0% (all P<0.001). Furthermore, 30-day survival increased: working-age patients, 5.8% to 22.0% (P<0.001); and early senior patients, 2.7% to 8.4% (P<0.001), whereas late senior patients experienced only a minor increase (1.5% to 2.0%; P=0.01). Overall, 3 of 9499 patients achieved 30-day survival if they met 2 criteria: had not achieved return of spontaneous circulation on hospital arrival and had not received a prehospital shock from a defibrillator. Conclusions - All age groups experienced a large temporal increase in survival on hospital arrival, but the increase in 30-day survival was most prominent in the young. With the use of only 2 criteria, it was possible to identify patients with a minimal chance of 30-day survival.

KW - Adolescent

KW - Adult

KW - Age Factors

KW - Aged

KW - Aged, 80 and over

KW - Blood Circulation

KW - Cardiopulmonary Resuscitation

KW - Denmark

KW - Electric Countershock

KW - Emergency Medical Services

KW - Female

KW - First Aid

KW - Humans

KW - Male

KW - Middle Aged

KW - Mortality

KW - Out-of-Hospital Cardiac Arrest

KW - Prognosis

KW - Registries

KW - Young Adult

U2 - 10.1161/circulationaha.114.013122

DO - 10.1161/circulationaha.114.013122

M3 - Journal article

C2 - 25747933

SN - 0009-7322

VL - 131

SP - 1536

EP - 1545

JO - Circulation

JF - Circulation

IS - 18

ER -