Miyoshi Hiromi, Nishikimi Mitsuaki, Kikutani Kazuya, Ohshimo Shinichiro, Shime Nobuaki
Department of Emergency and Critical Care Medicine, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan.
Resusc Plus. 2025 Feb 28;22:100917. doi: 10.1016/j.resplu.2025.100917. eCollection 2025 Mar.
Few studies have investigated the changes in the neurological status after 30 days post-arrest in out-of-hospital cardiac arrest (OHCA) patients according to the patient age. The aim of this study was to investigate the differences in the mid-term (from 30 days to 90 days) neurological changes after CA according to the age group.
We retrospectively analysed the data of all OHCA patients aged ≥1 year who showed return of spontaneous circulation and survived until 30 days after CA. We compared the proportions of patients who showed neurological deterioration from 30 to 90 days post-CA by age group (1-17, 18-39, 40-64, 65-79, ≥80 years). The neurological outcome was assessed by the Cerebral Performance Category (CPC) or Pediatric Cerebral Performance Category (PCPC) scale.
Of the 68,110 registered patients, we analysed the data of a total of 2,663 patients. The neurological deterioration rate and improvement rate from 30 to 90 days after CA in each age group were as follows: 1-17 years: 11.6% (8/69)/7.2% (5/69); 18-39 years: 8.3% (15/181)/6.1% (11/181); 40-64 years: 7.3% (72/982)/7.0% (69/982); 65-79 years: 13.5% (130/965)/8.1% (78/965); and ≥ 80 years: 24.2% (113/466)/4.9% (23/466). Multivariable logistic regression analysis showed a higher likelihood of mid-term neurological deterioration in patients aged ≥ 80 years than in those aged 1-17 years.
Most OHCA patients, irrespective of age, showed no change of the neurological status from 30 to 90 days after OHCA. However, a relatively large percentage of patients aged ≥80 years old showed significant neurological deterioration after 30 days post-OHCA.
很少有研究根据患者年龄调查院外心脏骤停（OHCA）患者心脏骤停后30天的神经状态变化。本研究的目的是调查根据年龄组划分的心脏骤停后中期（30天至90天）神经变化的差异。
我们回顾性分析了所有年龄≥1岁、恢复自主循环并存活至心脏骤停后30天的OHCA患者的数据。我们比较了按年龄组（1 - 17岁、18 - 39岁、40 - 64岁、65 - 79岁、≥80岁）划分的心脏骤停后30至90天出现神经功能恶化的患者比例。神经结局通过脑功能分类（CPC）或小儿脑功能分类（PCPC）量表进行评估。
在68,110名登记患者中，我们共分析了2,663名患者的数据。各年龄组心脏骤停后30至90天的神经功能恶化率和改善率如下：1 - 17岁：11.6%（8/69）/7.2%（5/69）；18 - 39岁：8.3%（15/181）/6.1%（11/181）；40 - 64岁：7.3%（72/982）/7.0%（69/982）；65 - 79岁：13.5%（130/965）/8.1%（78/965）；≥80岁：24.2%（113/466）/4.9%（23/466）。多变量逻辑回归分析显示，≥80岁的患者中期神经功能恶化的可能性高于1 - 17岁的患者。
大多数OHCA患者，无论年龄大小，在OHCA后30至90天神经状态无变化。然而，相对较大比例的≥80岁患者在OHCA后30天出现了明显的神经功能恶化。
