Age is related to neurological outcome in patients with out-of-hospital cardiac arrest (OHCA) receiving therapeutic hypothermia (TH)

Abstract

Introduction: In this study, we retrospectively reviewed the patients' outcomes after cardiac arrest based on age in one center, to determine whether geriatric patients had worse outcomes. Methods: This was a single-center, retrospective cohort study. The patients admitted to the intensive care unit on successful resuscitation after OHCA were retrospectively identified and evaluated. Results: This was a retrospective cohort study of patients over 18 years of-age with return of spontaneous circulation (ROSC) (N24 h) after cardiac arrest who were admitted to the emergency intensive care unit (EICU) and received post-cardiac arrest care between March 2007 and December 2013. Finally, a total of 295 patients were enrolled during the study period; of these, 79 patients (36.6%) had a good cerebral performance category (CPC). In stepwise multivariate analysis, young age (per 10 years) (odds ratio [OR] 1.42, 95% CI 1.00-1.99, p = 0.044), high hemoglobin level (per 1 g/dL) (OR 1.31, 95% CI 1.07-1.60, p = 0.008), non-diabetic patients (OR 15.21, 95% CI 1.85-125.3, p = 0.01), cardiogenic cardiac arrest (OR 8.68, 95% CI 3.72-20.30, p b 0.001), pre-hospital cardiopulmonary resuscitation (CPR) by bystander (OR 3.61, 95% CI 1.23-10.57, p = 0.019), short time from collapsed to ACLS (per 1 min) (OR 1.12, 95% CI 1.06-1.18, p b 0.001) had good CPC at 6-month post-admission. Conclusion: Elderly patients with OHCA had a poor neurological outcome; but several other factors were also related with the outcome. In decision-making for resuscitation, physicians should consider the patients' physiologic factors as well as age. (C) 2017 Elsevier Inc. All rights reserved.