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与年轻幸存者及普通人群相比,老年院外心脏骤停幸存者的长期预后。

Long-term outcome of elderly out-of-hospital cardiac arrest survivors as compared with their younger counterparts and the general population.

作者信息

Hiemstra Bart, Bergman Remco, Absalom Anthony R, van der Naalt Joukje, van der Harst Pim, de Vos Ronald, Nieuwland Wybe, Nijsten Maarten W, van der Horst Iwan C C

机构信息

Department of Critical Care, University of Groningen, University Medical Center Groningen, Hanzeplein 1, PO Box 30.001, Groningen, 9700 RB, The Netherlands.

University of Groningen, University Medical Center Groningen, Groningen, The Netherlands.

出版信息

Ther Adv Cardiovasc Dis. 2018 Dec;12(12):341-349. doi: 10.1177/1753944718792420. Epub 2018 Sep 20.

Abstract

BACKGROUND

: Over the past decade, prehospital and in-hospital treatment for out-of-hospital cardiac arrest (OHCA) has improved considerably. There are sparse data on the long-term outcome, especially in elderly patients. We studied whether elderly patients benefit to the same extent compared with younger patients and at long-term follow up as compared with the general population.

METHODS

: Between 2001 and 2010, data from all patients presented to our hospital after OHCA were recorded. Elderly patients (⩾75 years) were compared with younger patients. Neurological outcome was classified as cerebral performance category (CPC) at hospital discharge and long-term survival was compared with younger patients and predicted survival rates of the general population.

RESULTS

: Of the 810 patients admitted after OHCA, a total of 551 patients (68%) achieved return of spontaneous circulation, including 125 (23%) elderly patients with a mean age of 81 ± 5 years. In-hospital survival was lower in elderly patients compared with younger patients with rates of 33% versus 57% ( p < 0.001). A CPC of 1 was present in 73% of the elderly patients versus 86% of the younger patients ( p = 0.031). In 7.3% of the elderly patients, a CPC >2 was observed versus 2.5% of their younger counterparts ( p = 0.103). Elderly patients had a median survival of 6.5 [95% confidence interval (CI) 2.0-7.9] years compared with 7.7 (95% CI 7.5-7.9) years of the general population ( p = 0.019).

CONCLUSIONS

: The survival rate after OHCA in elderly patients is approximately half that of younger patients. Elderly patients who survive to discharge frequently have favorable neurological outcomes and a long-term survival that approximates that of the general population.

摘要

背景

在过去十年中,院外心脏骤停(OHCA)的院前和院内治疗有了显著改善。关于长期预后的数据很少,尤其是老年患者。我们研究了老年患者与年轻患者相比是否在同等程度上受益,以及与普通人群相比长期随访的情况。

方法

在2001年至2010年期间,记录了所有OHCA后送至我院的患者的数据。将老年患者(≥75岁)与年轻患者进行比较。神经功能预后在出院时分类为脑功能类别(CPC),并将长期生存率与年轻患者及普通人群的预测生存率进行比较。

结果

在810例OHCA后入院的患者中,共有551例(68%)实现了自主循环恢复,其中包括125例(23%)平均年龄为81±5岁的老年患者。老年患者的院内生存率低于年轻患者,分别为33%和57%(p<0.001)。73%的老年患者CPC为1,而年轻患者为86%(p=0.031)。7.3%的老年患者CPC>2,而年轻患者为2.5%(p=0.103)。老年患者的中位生存期为6.5[95%置信区间(CI)2.0 - 7.9]年,而普通人群为7.7(95%CI 7.5 - 7.9)年(p=0.019)。

结论

OHCA后老年患者的生存率约为年轻患者的一半。存活至出院的老年患者通常有良好的神经功能预后,长期生存率与普通人群相近。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6f30/6266245/335bd30b2fd2/10.1177_1753944718792420-fig1.jpg

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