Herlitz Johan, Eek Micael, Engdahl Johan, Holmberg Mikal, Holmberg Stig
Division of Cardiology, Sahlgrenska University Hospital, S-41345 Gothenburg, Sweden.
Resuscitation. 2003 Sep;58(3):309-17. doi: 10.1016/s0300-9572(03)00155-2.
To describe various factors at resuscitation and outcome among patients suffering from out-of-hospital cardiac arrest in relation to age.
All patients included in the Swedish Cardiac Arrest Registry during the period 1990-1999. The registry covers about 60% of all ambulance organisations in Sweden.
All patients reached by the ambulance crew and in whom resuscitative efforts were attempted. Crew witnessed cases were excluded. Only patients aged over 18 years were included. Patients were divided into three age groups: less than 65 years (n=7810), 65-75 years (n=7261) and over 75 years (n=8390).
The proportion of cases with a cardiac aetiology increased with increasing age (P<0.0001). The proportion of witnessed cases increased with increasing age among those with a non-cardiac aetiology (P<0.0001) and decreased with increasing age among cases with a cardiac aetiology (P=0.02). The proportion of patients exposed to bystander CPR decreased with increasing age (P<0.0001). The proportion of patients found in ventricular fibrillation (VF) decreased with increasing age among patients with a cardiac aetiology (P<0.0001) but was not related to age in those with a non-cardiac aetiology. The proportion of patients being alive after 1 month in the three age groups (youngest first) were: 4.5, 3.2 and 2.5% (P<0.0001). The corresponding figures for patients with a cardiac aetiology found in VF were: 10.7, 7.6 and 6.6% (P<0.0001). After multiple regression analysis controlling for other factors increasing age was still associated with decreased survival to 1 month (odds ratio 0.85; 95% confidence limits 0.80-0.91).
Among patients suffering from out-of-hospital cardiac arrest various factors at resuscitation, including initial rhythm, aetiology and bystander CPR, are strongly related to age. The chance of survival diminishes with increasing age. When correcting for the dissimilarities in terms of factors at resuscitation, age is still significantly associated with survival, being lower among the elderly.
描述院外心脏骤停患者复苏时的各种因素及与年龄相关的结局。
1990 - 1999年期间纳入瑞典心脏骤停登记处的所有患者。该登记处涵盖瑞典约60%的救护组织。
所有被救护人员送达且尝试进行复苏努力的患者。排除救护人员目击的病例。仅纳入18岁以上患者。患者分为三个年龄组：小于65岁（n = 7810）、65 - 75岁（n = 7261）和75岁以上（n = 8390）。
心脏病因导致的病例比例随年龄增长而增加（P < 0.0001）。非心脏病因患者中目击病例的比例随年龄增长而增加（P < 0.0001），而心脏病因患者中目击病例的比例随年龄增长而降低（P = 0.02）。接受旁观者心肺复苏的患者比例随年龄增长而降低（P < 0.0001）。心脏病因患者中发生心室颤动（VF）的患者比例随年龄增长而降低（P < 0.0001），但非心脏病因患者中该比例与年龄无关。三个年龄组（最年轻组在前）1个月后存活的患者比例分别为：4.5%、3.2%和2.5%（P < 0.0001）。VF中发现的心脏病因患者的相应数字为：10.7%、7.6%和6.6%（P < 0.0001）。在控制其他因素进行多元回归分析后，年龄增加仍与1个月生存率降低相关（比值比0.85；95%置信区间0.80 - 0.91）。
在院外心脏骤停患者中，复苏时的各种因素，包括初始心律、病因和旁观者心肺复苏，与年龄密切相关。生存机会随年龄增长而降低。校正复苏因素方面的差异后，年龄仍与生存显著相关，老年人的生存率较低。
