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Age‐associated outcomes after survived out‐of‐hospital cardiac arrest and subsequent target temperature management
Author(s) -
Pätz Toni,
Stelzig Katharina,
Pfeifer Rüdiger,
Pittl Undine,
Thiele Holger,
Busch Hans-Jörg,
Reinhard Iris,
Wolfrum Sebastian
Publication year - 2019
Publication title -
acta anaesthesiologica scandinavica
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.738
H-Index - 107
eISSN - 1399-6576
pISSN - 0001-5172
DOI - 10.1111/aas.13386
Subject(s) - medicine , return of spontaneous circulation , targeted temperature management , resuscitation , intensive care , defibrillation , intensive care unit , observational study , cardiopulmonary resuscitation , retrospective cohort study , population , emergency medicine , pediatrics , intensive care medicine , environmental health
Background The registry of the German Society of Intensive Care and Emergency Medicine was founded to analyze outcome of modern post‐resuscitation care. Methods A total of 902 patients were analyzed in this retrospective, multicenter, and population‐based observational trial on individuals suffering from out‐of‐hospital cardiac arrest. All patients had return of spontaneous circulation (ROSC) and received TTM after admitted to an intensive care unit. Outcome was focused on age and analyzed by creating 4 subgroups (<65, 65‐74, 75‐84, ≥85 years). Twenty‐eight day and 180‐day survival and a favorable neurological outcome according to the Cerebral Performance Category scale were evaluated as clinical endpoints. Results At 28‐day and 180‐day follow‐up, 44.8% and 53.4% of all patients had died, respectively. The evaluation of survival rate by age category revealed a higher mortality, but not an unfavorable neurological prognosis with increasing age. In multiple stepwise regressions, age, time to ROSC, bystander resuscitation, and cardiac cause of cardiac arrest were associated with increased chance of 180‐day survival and, in addition, bystander resuscitation, time of hypoxia, and a defibrillation performed by emergency medical service were associated with a favorable neurological outcome at 180‐day follow‐up. Conclusion Increasing age was associated with a higher mortality, but not with an unfavorable neurological outcome. The majority of survivors had a favorable neurologic outcome 6 months after cardiac arrest.