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. 2021 Aug;12(4):695-723.
doi: 10.1007/s41999-021-00454-y. Epub 2021 Mar 8.

The outcome of in- and out-hospital cardiopulmonary arrest in the older population: a scoping review

Rina Zanders  1 , Patrick Druwé  2 , Nele Van Den Noortgate  3 , Ruth Piers  3
Affiliations

The outcome of in- and out-hospital cardiopulmonary arrest in the older population: a scoping review

Rina Zanders et al. Eur Geriatr Med. 2021 Aug.

Abstract

Purpose: We aimed to collect the available evidence on outcome regarding survival and quality of life after cardiopulmonary resuscitation (CPR) following both in-hospital cardiac arrest (IHCA) and out-of-hospital cardiac arrest (OHCA) in the older population.

Methods: A scoping review was performed studying published reviews after 2008, focusing on outcome of CPR in patients aged ≥ 70 years following IHCA and OHCA. In addition, 11 (IHCA) and 19 (OHCA) eligible studies published after the 2 included reviews were analyzed regarding: return of spontaneous circulation, survival until hospital discharge, long-term survival, neurological outcome, discharge location or other measurements for quality of life (QoL).

Results: The survival until hospital discharge ranged between 11.6 and 28.5% for IHCA and 0-11.1% for OHCA, and declined with increasing age. The same trend was seen regarding 1-year survival rates with 5.7-25.0% and 0-10% following IHCA and OHCA, respectively. A good neurological outcome defined as a Cerebral Performance Category (CPC) 1-2 was found in 11.5-23.6% (IHCA) and up to 10.5% (OHCA) of all patients. However, the proportion of CPC 1-2 among patients surviving until hospital discharge was 82-93% (IHCA) and 77-91.6% (OHCA). Few studies included other QoL measures as an outcome variable. Other risk factors aside from age were identified, including nursing home residency, comorbidity, non-shockable rhythm, non-witnessed arrest. The level of frailty was not studied as a predictor of arrest outcome in the included studies.

Conclusions: Hospital survival rates following IHCA and OHCA in the older population improved in the recent decade, though do not exceed 28.5% and 11.1%, respectively. The effect of age on outcome remains controversial and age should not be used as the sole decision criterium whether to initiate CPR. Future research should study frailty and resilience as an independent predictor regardless of age, and add broader, extensive QoL measures as outcome variables.

Keywords: Age; CPR; Functional state; Neurological outcome; Quality of life; Survival.

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Conflict of interest statement

On behalf of all the authors, the corresponding author states that there is no conflict of interest.

Figures

Fig. 1
Fig. 1
Search and study selection: systematic reviews
Fig. 2
Fig. 2
Search and study selection: primary studies IHCA
Fig. 3
Fig. 3
Search and study selection: primary studies OHCA
See this image and copyright information in PMC

References

    1. Jacobs I, Nadkarni V, Bahr J, Berg RA, Billi JE, Bossaert L et al (2004) Cardiac arrest and cardiopulmonary resuscitation outcome reports: update and simplification of the Utstein templates for resuscitation registries. A statement for healthcare professionals from a task force of the international liaison committee on resuscitation (American Heart Association, European Resuscitation Council, Australian Resuscitation Council, New Zealand Resuscitation Council, Heart and Stroke Foundation of Canada, InterAmerican Heart Foundation, Resuscitation Council of Southern Africa). Resuscitation 63(3):233–249 (PubMed PMID: 15582757. Epub 2004/12/08. eng) - PubMed
    1. Matsuyama T, Kitamura T, Kiyohara K, Kiguchi T, Kobayashi D, Nishiyama C et al (2018) Assessment of the 11-year nationwide trend of out-of-hospital cardiac arrest cases among elderly patients in Japan (2005–2015). Resuscitation 131:83–90 (PubMed PMID: 30099119. Epub 2018/08/14.eng) - PubMed
    1. Tarras SL, Napolitano LM. Critical Care Epidemiology and Outcomes/Resource Use in the Elderly. In: Luchette FA, Yelon JA, editors. Geriatric trauma and critical care. Cham: Springer International Publishing; 2017. pp. 355–366.
    1. Neumar RW, Nolan JP, Adrie C, Aibiki M, Berg RA, Bottiger BW et al (2008) Post-cardiac arrest syndrome: epidemiology, pathophysiology, treatment, and prognostication. A consensus statement from the International Liaison Committee on Resuscitation (American Heart Association, Australian and New Zealand Council on Resuscitation, European Resuscitation Council, Heart and Stroke Foundation of Canada, InterAmerican Heart Foundation, Resuscitation Council of Asia, and the Resuscitation Council of Southern Africa); the American Heart Association Emergency Cardiovascular Care Committee; the Council on Cardiovascular Surgery and Anesthesia; the Council on Cardiopulmonary, Perioperative, and Critical Care; the Council on Clinical Cardiology; and the Stroke Council. Circulation 118(23):2452–83 (PubMed PMID: 18948368. Epub 2008/10/25.eng) - PubMed
    1. Kim J-H, Oh Ym, So BH, Hong TY, Lee WJ, Choi SP et al (2008) Systemic complications of comatose survivors following cardiopulmonary resuscitation

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