Age and other determinants of survival after in-hospital cardiopulmonary resuscitation

Abstract

A retrospective review of 274 patients who received in-hospital cardiopulmonary resuscitation was performed to determine whether age is independently associated with survival to discharge. Eighty-two (29.9 per cent) of the 274 patients were resuscitated initially, but only 25 (9.1 per cent) were discharged alive. Survival to discharge was significantly poorer in patients aged greater than or equal to 70 years (6/175; 3.4 per cent) than in patients less than 70 years old (19/99; 19.2 per cent) (p less than 0.001). Severity of illness, assessed by the number of diagnoses and a multifactorial morbidity index, did not differ between the two age groups. The best results were obtained with witnessed arrests, ventricular arrhythmias and resuscitation lasting less than 5 minutes; however, elderly patients were less likely to be resuscitated in all circumstances. Age (r = -0.31, p less than 0.001) and the morbidity index (r = -0.18, p less than 0.05) were independently associated with survival by multivariate analysis. These results indicate that advanced age is an important independent determinant of survival after resuscitation. This should be taken into consideration when making in-hospital resuscitation decisions.