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Comparative Study
. 2018 Dec;12(12):341-349.
doi: 10.1177/1753944718792420. Epub 2018 Sep 20.

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

Bart Hiemstra  1 , Remco Bergman  2 , Anthony R Absalom  2 , Joukje van der Naalt  2 , Pim van der Harst  2 , Ronald de Vos  2 , Wybe Nieuwland  2 , Maarten W Nijsten  2 , Iwan C C van der Horst  2
Affiliations
Comparative Study

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

Bart Hiemstra et al. Ther Adv Cardiovasc Dis. 2018 Dec.

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.

Keywords: cardiopulmonary resuscitation; cerebral performance; elderly; long-term mortality; out-of-hospital cardiac arrest; prognosis.

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Conflict of interest statement

Conflict of interest statement: The authors declare that there is no conflict of interest.

Figures

Figure 1.
Figure 1.
Flow diagram of study population. CPC, cerebral performance category; OHCA, out-of-hospital cardiac arrest; ROSC, return of spontaneous circulation.
Figure 2.
Figure 2.
Survival curves of younger (< 75 years) and elderly (⩾ 75 years) patients. OHCA, out-of-hospital cardiac arrest.
Figure 3.
Figure 3.
Survival curve elderly versus matched control population with 95% confidence intervals.
See this image and copyright information in PMC

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