• Journal of cardiology · Jan 2017

    Observational Study

    Prehospital predictors of neurological outcomes in out-of-hospital cardiac arrest patients aged 95 years and older: A nationwide population-based observational study.

    • Akira Funada, Yoshikazu Goto, Tetsuo Maeda, Hayato Tada, Ryota Teramoto, Yoshihiro Tanaka, Kenshi Hayashi, and Masakazu Yamagishi.
    • Department of Emergency and Critical Care Medicine, Kanazawa University Hospital, Kanazawa, Japan; Division of Cardiovascular Medicine, Kanazawa University Graduate School of Medical Science, Kanazawa University, Kanazawa, Japan.
    • J Cardiol. 2017 Jan 1; 69 (1): 340-344.

    BackgroundPopulation aging has rapidly progressed in Japan. However, few data exist regarding the characteristics of extremely elderly patients with out-of-hospital cardiac arrest (OHCA). We aimed to determine the prehospital predictors of one-month survival with favorable neurological outcomes (Cerebral Performance Category scale, category 1 or 2; CPC 1-2) in this population.MethodsWe investigated 23,520 OHCA patients aged ≥95 years from a prospectively recorded, nationwide, Utstein-style Japanese database between 2008 and 2012. The primary study endpoint was one-month CPC 1-2 after OHCA.ResultsThe one-month CPC 1-2 rate was 0.27% (63/23,520). Only two variables were significantly associated with one-month CPC 1-2 in a multivariate logistic regression model: prehospital return of spontaneous circulation (ROSC) [adjusted odds ratio (aOR), 94.4; 95% confidential interval (CI), 50.1-191.7] and emergency medical service (EMS)-witnessed arrest (aOR, 5.1; 95% CI, 2.6-10.2). When stratified by these two predictors, the one-month CPC 1-2 rates were 20.2% (18/89) for patients who had both prehospital ROSC and EMS-witnessed arrest, 4.2% (33/783) for those who had prehospital ROSC without EMS-witnessed arrest, 0.28% (3/1065) for those who had EMS-witnessed arrest without prehospital ROSC, and 0.04% (9/21,583) for those who had neither predictor, respectively.ConclusionsThe crucial prehospital predictors for one-month CPC 1-2 in elderly OHCA patients aged ≥95 years in Japan were prehospital ROSC and EMS-witnessed arrest and the former was the predominant predictor.Copyright © 2016 Japanese College of Cardiology. Published by Elsevier Ltd. All rights reserved.

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