Akira Funada1, Yoshikazu Goto2, Tetsuo Maeda3, Hayato Tada1, Ryota Teramoto1, Yoshihiro Tanaka1, Kenshi Hayashi4, Masakazu Yamagishi4. 1. Department of Emergency and Critical Care Medicine, Kanazawa University Hospital, Kanazawa, Japan; Division of Cardiovascular Medicine, Kanazawa University Graduate School of Medical Science, Kanazawa University, Kanazawa, Japan. 2. Department of Emergency and Critical Care Medicine, Kanazawa University Hospital, Kanazawa, Japan. Electronic address: gotoyosh@med.kanazawa-u.ac.jp. 3. Department of Emergency and Critical Care Medicine, Kanazawa University Hospital, Kanazawa, Japan. 4. Division of Cardiovascular Medicine, Kanazawa University Graduate School of Medical Science, Kanazawa University, Kanazawa, Japan.
Abstract
BACKGROUND: Population aging has rapidly progressed in Japan. However, few data exist regarding the characteristics of extremely elderly patients with out-of-hospital cardiac arrest (OHCA). We aimed to determine the prehospital predictors of one-month survival with favorable neurological outcomes (Cerebral Performance Category scale, category 1 or 2; CPC 1-2) in this population. METHODS: We investigated 23,520 OHCA patients aged ≥95 years from a prospectively recorded, nationwide, Utstein-style Japanese database between 2008 and 2012. The primary study endpoint was one-month CPC 1-2 after OHCA. RESULTS: The one-month CPC 1-2 rate was 0.27% (63/23,520). Only two variables were significantly associated with one-month CPC 1-2 in a multivariate logistic regression model: prehospital return of spontaneous circulation (ROSC) [adjusted odds ratio (aOR), 94.4; 95% confidential interval (CI), 50.1-191.7] and emergency medical service (EMS)-witnessed arrest (aOR, 5.1; 95% CI, 2.6-10.2). When stratified by these two predictors, the one-month CPC 1-2 rates were 20.2% (18/89) for patients who had both prehospital ROSC and EMS-witnessed arrest, 4.2% (33/783) for those who had prehospital ROSC without EMS-witnessed arrest, 0.28% (3/1065) for those who had EMS-witnessed arrest without prehospital ROSC, and 0.04% (9/21,583) for those who had neither predictor, respectively. CONCLUSIONS: The crucial prehospital predictors for one-month CPC 1-2 in elderly OHCA patients aged ≥95 years in Japan were prehospital ROSC and EMS-witnessed arrest and the former was the predominant predictor.
BACKGROUND: Population aging has rapidly progressed in Japan. However, few data exist regarding the characteristics of extremely elderly patients with out-of-hospital cardiac arrest (OHCA). We aimed to determine the prehospital predictors of one-month survival with favorable neurological outcomes (Cerebral Performance Category scale, category 1 or 2; CPC 1-2) in this population. METHODS: We investigated 23,520 OHCA patients aged ≥95 years from a prospectively recorded, nationwide, Utstein-style Japanese database between 2008 and 2012. The primary study endpoint was one-month CPC 1-2 after OHCA. RESULTS: The one-month CPC 1-2 rate was 0.27% (63/23,520). Only two variables were significantly associated with one-month CPC 1-2 in a multivariate logistic regression model: prehospital return of spontaneous circulation (ROSC) [adjusted odds ratio (aOR), 94.4; 95% confidential interval (CI), 50.1-191.7] and emergency medical service (EMS)-witnessed arrest (aOR, 5.1; 95% CI, 2.6-10.2). When stratified by these two predictors, the one-month CPC 1-2 rates were 20.2% (18/89) for patients who had both prehospital ROSC and EMS-witnessed arrest, 4.2% (33/783) for those who had prehospital ROSC without EMS-witnessed arrest, 0.28% (3/1065) for those who had EMS-witnessed arrest without prehospital ROSC, and 0.04% (9/21,583) for those who had neither predictor, respectively. CONCLUSIONS: The crucial prehospital predictors for one-month CPC 1-2 in elderly OHCA patients aged ≥95 years in Japan were prehospital ROSC and EMS-witnessed arrest and the former was the predominant predictor.
Authors: 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 Journal: Ther Adv Cardiovasc Dis Date: 2018-09-20
Authors: Jordi Sans Roselló; Maria Vidal-Burdeus; Pablo Loma-Osorio; Alexandra Pons Riverola; Gil Bonet Pineda; Nabil El Ouaddi; Jaime Aboal; Albert Ariza Solé; Claudia Scardino; Cosme García-García; Estefanía Fernández-Peregrina; Alessandro Sionis Journal: Int J Cardiol Heart Vasc Date: 2022-04-27