Relationship between age and outcomes of comatose cardiac arrest survivors in a setting without withdrawal of life support. (June 2017)

• Record Type: Journal Article
• Authors: Lee, Byung Kook; Lee, Seung Joon; Park, Chi Ho; Jeung, Kyung Woon; Jung, Yong Hun; Lee, Dong Hun; Lee, Sung Min; Kim, Hyun Chang; Min, Yong Il
• Is Part Of: Resuscitation. Volume 115(2017)
• Page Start: 75
• Page End: 81
• Publication Date: 2017-06
• Subjects: TTM targeted temperature management -- WLS withdrawal of life support -- ECMO extracorporeal membrane oxygenation -- OHCA out of-hospital cardiac arrest -- CPR cardiopulmonary resuscitation -- CPC Cerebral Performance Categories -- ROSC restoration of spontaneous circulation -- GCS Glasgow Coma Scale -- SOFA sequential organ failure assessment -- OR odds ratio -- HR hazard ratio -- CI confidence interval; Heart arrest -- Induced hypothermia -- Aged -- Prognosis; Resuscitation -- Periodicals; Resuscitation -- Periodicals; Réanimation -- Périodiques; Electronic journals; 616.025
• DOI: 10.1016/j.resuscitation.2017.04.009
• Languages: English
• ISSNs: 0300-9572

Abstract

Abstract: Aim of the study: Previous studies on the relationship between age and outcomes after cardiac arrest were performed in settings where the majority of patients died after the withdrawal of life support (WLS). We examined the association between age and outcomes of comatose cardiac arrest survivors in a setting where WLS was not performed. Methods: This single-centre retrospective observational study included adult comatose cardiac arrest survivors treated with targeted temperature management. In Korea, WLS is not permitted unless the patient is pronounced brain-dead. The primary outcome was poor neurologic outcome at hospital discharge, defined as Cerebral Performance Categories scores of 3–5. The secondary outcomes were in-hospital and six-month mortalities. Results: A total of 534 patients were analysed. In multivariate analysis, age was not associated with in-hospital mortality (odds ratio [OR], 1.01; 95% confidence interval [CI], 0.99–1.02), but it was independently associated with neurologic outcome at hospital discharge (OR, 1.03; 95% CI, 1.02–1.05) and six-month mortality (OR, 1.05; 95% CI, 1.03–1.07). When age was categorised into 10-year intervals, age groups less than 61–70 years had significantly lower OR for poor neurologic outcome compared with the reference group (61–70 years), while the OR for poor neurologic outcome in age groups greater than 70 years did not differ from that in the reference group. Conclusion: In a setting where WLS is not performed, we found that age was not associated with in-hospital mortality but was independently associated with neurologic outcome at hospital discharge and six-month mortality.