• Sharon Einav, Andrea Cortegiani, and Esther-Lee Marcus.
• anesthesiologist and intensivist, Director of Surgical Intensive Care, Shaare Zedek Medical Center and Associate Professor at the Hebrew University-Hadassah Faculty of Medicine, Ein-Kerem, Jerusalem, Israel.
• Curr Opin Anaesthesiol. 2021 Feb 1; 34 (1): 404740-47.

Purpose Of ReviewTo describe the epidemiology, prognostication, and treatment of out- and in-hospital cardiac arrest (OHCA and IHCA) in elderly patients.Recent FindingsElderly patients undergoing cardiac arrest (CA) challenge the appropriateness of attempting cardiopulmonary resuscitation (CPR). Current literature suggests that factors traditionally associated with survival to hospital discharge and neurologically intact survival after CA cardiac arrest in general (e.g. presenting ryhthm, bystander CPR, targeted temperature management) may not be similarly favorable in elderly patients. Alternative factors meaningful for outcome in this special population include prearrest functional status, comorbidity load, the specific age subset within the elderly population, and CA location (i.e., nursing versus private home). Age should therefore not be a standalone criterion for withholding CPR. Attempts to perform CPR in an elderly patient should instead stem from a shared decision-making process.SummaryAn appropriate CPR attempt is an attempt resulting in neurologically intact survival. Appropriate CPR in elderly patients requires better risk classification. Future research should therefore focus on the associations of specific within-elderly age subgroups, comorbidities, and functional status with neurologically intact survival. Reporting must be standardized to enable such evaluation.Copyright © 2020 Wolters Kluwer Health, Inc. All rights reserved.

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