O'Keeffe S, Redahan C, Keane P, Daly K
Department of Cardiology, University College Hospital, Galway, Ireland.
Q J Med. 1991 Dec;81(296):1005-10. doi: 10.1093/qjmed/81.3.1005.
A retrospective review of 274 patients who received in-hospital cardiopulmonary resuscitation was performed to determine whether age is independently associated with survival to discharge. Eighty-two (29.9 per cent) of the 274 patients were resuscitated initially, but only 25 (9.1 per cent) were discharged alive. Survival to discharge was significantly poorer in patients aged greater than or equal to 70 years (6/175; 3.4 per cent) than in patients less than 70 years old (19/99; 19.2 per cent) (p less than 0.001). Severity of illness, assessed by the number of diagnoses and a multifactorial morbidity index, did not differ between the two age groups. The best results were obtained with witnessed arrests, ventricular arrhythmias and resuscitation lasting less than 5 minutes; however, elderly patients were less likely to be resuscitated in all circumstances. Age (r = -0.31, p less than 0.001) and the morbidity index (r = -0.18, p less than 0.05) were independently associated with survival by multivariate analysis. These results indicate that advanced age is an important independent determinant of survival after resuscitation. This should be taken into consideration when making in-hospital resuscitation decisions.
对274例接受院内心肺复苏的患者进行回顾性研究,以确定年龄是否与出院存活率独立相关。274例患者中,82例(29.9%)最初复苏成功,但只有25例(9.1%)存活出院。年龄大于或等于70岁的患者出院存活率(6/175;3.4%)显著低于70岁以下患者(19/99;19.2%)(p<0.001)。通过诊断数量和多因素发病指数评估的疾病严重程度在两个年龄组之间没有差异。目击心脏骤停、室性心律失常和持续时间少于5分钟的复苏效果最佳;然而,在所有情况下老年患者复苏成功的可能性较小。多因素分析显示,年龄(r=-0.31,p<0.001)和发病指数(r=-0.18,p<0.05)与存活率独立相关。这些结果表明,高龄是复苏后存活的一个重要独立决定因素。在做出院内复苏决策时应考虑这一点。