Survival After Out-of-Hospital Cardiac Arrest in Relation to Age and Early Identification of Patients With Minimal Chance of Long-Term Survival
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Survival After Out-of-Hospital Cardiac Arrest in Relation to Age and Early Identification of Patients With Minimal Chance of Long-Term Survival. / Wissenberg, Mads; Folke, Fredrik; Hansen, Carolina Malta; Lippert, Freddy K; Kragholm, Kristian; Risgaard, Bjarke; Rajan, Shahzleen; Karlsson, Lena; Søndergaard, Kathrine Bach; Hansen, Steen M; Mortensen, Rikke Normark; Weeke, Peter; Christensen, Erika Frischknecht; Nielsen, Søren L; Gislason, Gunnar H; Køber, Lars; Torp-Pedersen, Christian.
In: Circulation, Vol. 131, No. 18, 05.05.2015, p. 1536-45.Research output: Contribution to journal › Journal article › Research › peer-review
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TY - JOUR
T1 - Survival After Out-of-Hospital Cardiac Arrest in Relation to Age and Early Identification of Patients With Minimal Chance of Long-Term Survival
AU - Wissenberg, Mads
AU - Folke, Fredrik
AU - Hansen, Carolina Malta
AU - Lippert, Freddy K
AU - Kragholm, Kristian
AU - Risgaard, Bjarke
AU - Rajan, Shahzleen
AU - Karlsson, Lena
AU - Søndergaard, Kathrine Bach
AU - Hansen, Steen M
AU - Mortensen, Rikke Normark
AU - Weeke, Peter
AU - Christensen, Erika Frischknecht
AU - Nielsen, Søren L
AU - Gislason, Gunnar H
AU - Køber, Lars
AU - Torp-Pedersen, Christian
N1 - © 2015 American Heart Association, Inc.
PY - 2015/5/5
Y1 - 2015/5/5
N2 - BACKGROUND: Survival after out-of-hospital cardiac arrest has increased during the last decade in Denmark. We aimed to study the impact of age on changes in survival and whether it was possible to identify patients with minimal chance of 30-day survival.METHODS AND RESULTS: Using data from the nationwide Danish Cardiac Arrest Registry (2001─2011), we identified 21 480 patients ≥18 years old with a presumed cardiac-caused out-of-hospital cardiac arrest for which resuscitation was attempted. Patients were divided into 3 preselected age-groups: working-age patients 18 to 65 years of age (33.7%), early senior patients 66 to 80 years of age (41.5%), and late senior patients >80 years of age (24.8%). Characteristics in working-age patients, early senior patients, and late senior patients were as follows: witnessed arrest in 53.8%, 51.1%, and 52.1%; bystander cardiopulmonary resuscitation in 44.7%, 30.3%, and 23.4%; and prehospital shock from a defibrillator in 54.7%, 45.0%, and 33.8% (all P<0.05). Between 2001 and 2011, return of spontaneous circulation on hospital arrival increased: working-age patients, from 12.1% to 34.6%; early senior patients, from 6.4% to 21.5%; and late senior patients, from 4.0% to 15.0% (all P<0.001). Furthermore, 30-day survival increased: working-age patients, 5.8% to 22.0% (P<0.001); and early senior patients, 2.7% to 8.4% (P<0.001), whereas late senior patients experienced only a minor increase (1.5% to 2.0%; P=0.01). Overall, 3 of 9499 patients achieved 30-day survival if they met 2 criteria: had not achieved return of spontaneous circulation on hospital arrival and had not received a prehospital shock from a defibrillator.CONCLUSIONS: All age groups experienced a large temporal increase in survival on hospital arrival, but the increase in 30-day survival was most prominent in the young. With the use of only 2 criteria, it was possible to identify patients with a minimal chance of 30-day survival.
AB - BACKGROUND: Survival after out-of-hospital cardiac arrest has increased during the last decade in Denmark. We aimed to study the impact of age on changes in survival and whether it was possible to identify patients with minimal chance of 30-day survival.METHODS AND RESULTS: Using data from the nationwide Danish Cardiac Arrest Registry (2001─2011), we identified 21 480 patients ≥18 years old with a presumed cardiac-caused out-of-hospital cardiac arrest for which resuscitation was attempted. Patients were divided into 3 preselected age-groups: working-age patients 18 to 65 years of age (33.7%), early senior patients 66 to 80 years of age (41.5%), and late senior patients >80 years of age (24.8%). Characteristics in working-age patients, early senior patients, and late senior patients were as follows: witnessed arrest in 53.8%, 51.1%, and 52.1%; bystander cardiopulmonary resuscitation in 44.7%, 30.3%, and 23.4%; and prehospital shock from a defibrillator in 54.7%, 45.0%, and 33.8% (all P<0.05). Between 2001 and 2011, return of spontaneous circulation on hospital arrival increased: working-age patients, from 12.1% to 34.6%; early senior patients, from 6.4% to 21.5%; and late senior patients, from 4.0% to 15.0% (all P<0.001). Furthermore, 30-day survival increased: working-age patients, 5.8% to 22.0% (P<0.001); and early senior patients, 2.7% to 8.4% (P<0.001), whereas late senior patients experienced only a minor increase (1.5% to 2.0%; P=0.01). Overall, 3 of 9499 patients achieved 30-day survival if they met 2 criteria: had not achieved return of spontaneous circulation on hospital arrival and had not received a prehospital shock from a defibrillator.CONCLUSIONS: All age groups experienced a large temporal increase in survival on hospital arrival, but the increase in 30-day survival was most prominent in the young. With the use of only 2 criteria, it was possible to identify patients with a minimal chance of 30-day survival.
KW - Adolescent
KW - Adult
KW - Age Factors
KW - Aged
KW - Aged, 80 and over
KW - Blood Circulation
KW - Cardiopulmonary Resuscitation
KW - Denmark
KW - Electric Countershock
KW - Emergency Medical Services
KW - Female
KW - First Aid
KW - Humans
KW - Male
KW - Middle Aged
KW - Mortality
KW - Out-of-Hospital Cardiac Arrest
KW - Prognosis
KW - Registries
KW - Young Adult
U2 - 10.1161/CIRCULATIONAHA.114.013122
DO - 10.1161/CIRCULATIONAHA.114.013122
M3 - Journal article
C2 - 25747933
VL - 131
SP - 1536
EP - 1545
JO - Circulation
JF - Circulation
SN - 0009-7322
IS - 18
ER -
ID: 162336271