Out-of-hospital cardiac arrests in the older age groups in Melbourne, Australia

Deasy, C., Bray, J.E., Smith, K., Harriss, L.R., Bernard, S.A., and Cameron, P. (2011) Out-of-hospital cardiac arrests in the older age groups in Melbourne, Australia. Resuscitation, 82 (4). pp. 398-403.

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Abstract

Background: Controversy exists around CPR in the elderly. The characteristics and outcomes of out-of-hospital cardiac arrest (OHCA) in this age group were studied in Melbourne, Australia.

Methods: The Victorian Ambulance Cardiac Arrest Registry (VACAR) was searched for all OHCAs not witnessed by Emergency Medical Services (EMS) occurring in those aged 65 years and older.

Results: Between 2000 and 2009 there were 30,006 OHCAs of which 9703 (32%) were in people 65–79 years of age, 6430 (21%) in octogenarians, 1530 (5%) in nonagenarian and 40 (0.1%) in centenarians. Rates of attempted resuscitation decreased with advancing age: 48% for those aged 65–79 years, 39% for octogenarians, 31% for nonagenarians and 17% for centenarians. Similarly rates of survival to hospital discharge decreased with age: 8% for those aged 65–79 years, 4% for octogenarians, 2% for nonagenarians; for 65–79 year olds, octogenarians and nonagenarians survival if in VF/VT was – 17%, 10% and 4%; asystole – 1%, 1% and 0.5%; and PEA – 6%, 3% and 3%, respectively. Multivariable logistic regression shows that between 2000 and 2009 rates of transportation with return of spontaneous circulation have improved for both shockable and non-shockable rhythms [OR 95% CI 1.07(1.04–1.10) and 1.16(1.12–1.20), respectively] but survival to hospital discharge has improved in the shockable rhythm group only [OR 1.12(1.07–1.16)].

Conclusion: Outcomes for OHCA with shockable rhythm have improved over the last 10 years for people aged 65 years and over. Quality of life studies should be performed to help inform the community and EMS on appropriate resuscitative efforts.

Item ID: 40482
Item Type: Article (Refereed Research - C1)
Keywords: cardiac arrest; out-of-hospital; elderly; octogenarians; nonagenarians; centenarians; outcomes; EMS; emergency medical services; emergency; resuscitation; cardiopulmonary resuscitation; CPR
ISSN: 1873-1570
Funders: Monash University
Date Deposited: 16 Sep 2015 03:25
FoR Codes: 11 MEDICAL AND HEALTH SCIENCES > 1103 Clinical Sciences > 110305 Emergency Medicine @ 34%
11 MEDICAL AND HEALTH SCIENCES > 1117 Public Health and Health Services > 111706 Epidemiology @ 33%
11 MEDICAL AND HEALTH SCIENCES > 1102 Cardiovascular Medicine and Haematology > 110201 Cardiology (incl Cardiovascular Diseases) @ 33%
SEO Codes: 92 HEALTH > 9201 Clinical Health (Organs, Diseases and Abnormal Conditions) > 920103 Cardiovascular System and Diseases @ 34%
92 HEALTH > 9202 Health and Support Services > 920204 Evaluation of Health Outcomes @ 33%
92 HEALTH > 9204 Public Health (excl. Specific Population Health) > 920409 Injury Control @ 33%
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