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Cardiocerebral Resuscitation Improves Out‐of‐Hospital Survival in Older Adults
Author(s) -
Mohler M. Jane,
Wendel Christopher S.,
Mosier Jarrod,
Itty Ajit,
Fain Mindy,
Clark Lani,
Bobrow Bentley,
Sanders Arthur B.
Publication year - 2011
Publication title -
journal of the american geriatrics society
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.992
H-Index - 232
eISSN - 1532-5415
pISSN - 0002-8614
DOI - 10.1111/j.1532-5415.2011.03400.x
Subject(s) - medicine , context (archaeology) , demographics , emergency medicine , resuscitation , cohort , cardiopulmonary resuscitation , advance care planning , odds ratio , prospective cohort study , odds , gerontology , palliative care , demography , logistic regression , paleontology , nursing , sociology , biology
OBJECTIVES: To compare the survival and neurological status of people aged 65 and older receiving cardiocerebral resuscitation (CCR) with that of those receiving standard advanced life support (Std‐ALS), as well as predictors of survival. DESIGN: Historical prospective cohort study. SETTING: The Save Hearts in Arizona Registry (SHARE). PARTICIPANTS: Persons who had experienced cardiac arrest receiving CCR or Std‐ALS. MEASUREMENTS: Patient demographics, emergency medical service events, survival to hospital discharge, and out‐of‐hospital cardiac arrest (OHCA) outcomes were obtained from Arizona hospital records and Bureau of Public Health Statistics from 2005 to 2008. RESULTS: People receiving CCR were twice as likely to survive as those receiving Std‐ALS (adjusted odds ratio=2.0, P =.005). An additional 20 per 1,000 older adults would survive, above the background survival rate of Std‐ALS, if given CCR. More than 96% of those receiving CCR had good or moderate neurological outcomes, compared with 89% of those receiving Std.‐ALS ( P =.41). CONCLUSION: CCR is associated with superior survival outcomes than Std‐ALS for OHCAs in people aged 65 and older. Use of CCR in older adults without known do‐not‐resuscitate status is warranted. These findings should be understood within the broader context of the essential role of comprehensive advance care planning in providing care consistent with patient goals and values.