Tresch D, Heudebert G, Kutty K, Ohlert J, VanBeek K, Masi A
Department of Cardiology, Medical College of Wisconsin, Milwaukee.
J Am Geriatr Soc. 1994 Feb;42(2):137-41. doi: 10.1111/j.1532-5415.1994.tb04940.x.
To compare the clinical characteristics and survival of elderly and younger hospitalized patients who sustain cardiac arrest and receive cardiopulmonary resuscitation (CPR) in the 1990's and to assess predictors of survival.
Retrospective survey of cardiac arrest database and hospital charts, plus telephone follow-up.
450-bed acute care teaching hospital.
Seventy-eight hospitalized patients 70 years or older and 73 hospitalized patients under 70 years of age.
Survey of cardiac arrest data base, hospital charts, and telephonic follow-up to allow (1) comparison of clinical characteristics, survival, and long-term follow-up between two age groups and (2) univariate and multivariate analysis of predictors of mortality.
Pre-arrest clinical characteristics were not significantly different between the age groups. Prior to arrest the majority of patients were functionally active, and over one-third were hospitalized for acute coronary artery syndromes. In approximately 85% of the patients, the arrest was witnessed, and 70% of the patients had their cardiac rhythm monitored at onset of the arrest. Survival was not significantly different between the age groups; 26% of the total 151 patients were discharged. No significant difference was noted in pre-post arrest functional status of survivors. Survival at 1, 2, and 3 years in elderly and younger survivors was 86% versus 80%, 76% versus 67%, and 71% versus 61%, respectively. Multivariate analysis identified the presence of coronary artery disease, admission systolic blood pressure, and functional level to be independent pre-arrest predictors of mortality. At the time of the arrest, the initial cardiac rhythm and duration of CPR were found to be independent predictors of mortality.
Elderly patients hospitalized in the 1990's who receive CPR have outcomes similar to younger patients who receive CPR. The favorable outcome in the elderly patients may reflect patient selection: the majority of our patients were functionally active prior to hospitalization, without multiple serious illnesses; many were hospitalized for acute coronary artery syndromes; and, in most cases, the arrest was witnessed with the patient's cardiac rhythm monitored at onset of the arrest.
比较20世纪90年代发生心脏骤停并接受心肺复苏（CPR）的老年和年轻住院患者的临床特征及生存率，并评估生存预测因素。
对心脏骤停数据库和医院病历进行回顾性调查，并进行电话随访。
拥有450张床位的急性护理教学医院。
78名70岁及以上的住院患者和73名70岁以下的住院患者。
对心脏骤停数据库、医院病历进行调查，并进行电话随访，以（1）比较两个年龄组的临床特征、生存率和长期随访情况，（2）对死亡预测因素进行单因素和多因素分析。
两个年龄组在心脏骤停前的临床特征无显著差异。心脏骤停前，大多数患者功能活动良好，超过三分之一的患者因急性冠状动脉综合征住院。约85%的患者心脏骤停被目击，70%的患者在心脏骤停发作时进行了心律监测。两个年龄组的生存率无显著差异；151名患者中26%出院。幸存者心脏骤停前后的功能状态无显著差异。老年和年轻幸存者1年、2年和3年的生存率分别为86%对80%、76%对67%、71%对61%。多因素分析确定冠状动脉疾病、入院收缩压和功能水平是心脏骤停前独立的死亡预测因素。在心脏骤停时，初始心律和心肺复苏持续时间是死亡的独立预测因素。
20世纪90年代接受心肺复苏的住院老年患者的预后与接受心肺复苏的年轻患者相似。老年患者的良好预后可能反映了患者的选择：我们的大多数患者在住院前功能活动良好，没有多种严重疾病；许多患者因急性冠状动脉综合征住院；而且，在大多数情况下，心脏骤停被目击，且患者在心脏骤停发作时进行了心律监测。
