• Age and ageing · Jul 2014

    Review

    The chance of survival and the functional outcome after in-hospital cardiopulmonary resuscitation in older people: a systematic review.

    • Myke S van Gijn, Dionne Frijns, Esther M M van de Glind, Barbara C van Munster, and Marije E Hamaker.
    • Geriatric Medicine, Diakonessenhuis, Prof Lorentzlaan 76, Zeist, Utrecht 3707 HL, Netherlands.
    • Age Ageing. 2014 Jul 1;43(4):456-63.

    Backgroundphysicians are frequently confronted with the question whether cardiopulmonary resuscitation (CPR) is a medically appropriate treatment for older people. For physicians, patients and relatives, it is important to know the chance of survival and the functional outcome after CPR in order to make an informed decision.Methodsa systematic search was performed in MEDLINE, Embase and Cochrane up to November 2012. Studies that were included described the chance of survival, the social status and functional outcome after in-hospital CPR in older people aged 70 years and above.Resultswe identified 11,377 publications of which 29 were included in this review; 38.6% of the patients who were 70 years and older had a return of spontaneous circulation. More than half of the patients who initially survived resuscitation died in the hospital before hospital discharge. The pooled survival to discharge after in-hospital CPR was 18.7% for patients between 70 and 79 years old, 15.4% for patients between 80 and 89 years old and 11.6% for patients of 90 years and older. Data on social and functional outcome after surviving CPR were scarce and contradictory.Conclusionsthe chance of survival to hospital discharge for in-hospital CPR in older people is low to moderate (11.6-18.7%) and decreases with age. However, evidence about functional or social outcomes after surviving CPR is scarce. Prospective studies are needed to address this issue and to identify pre-arrest factors that can predict survival in the older people in order to define subgroups that could benefit from CPR.© The Author 2014. Published by Oxford University Press on behalf of the British Geriatrics Society. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

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