Abstract 15905: Monocyte Subsets Predict Mortality After Cardiac Arrest

Circulation ◽  
2020 ◽  
Vol 142 (Suppl_3) ◽  
Author(s):  
Konstantin Krychtiuk ◽  
Max Lenz ◽  
Bernhard Richter ◽  
Philipp Hohensinner ◽  
Stefan Kastl ◽  
...  
Keyword(s):  
Cardiac Arrest ◽  
Cerebral Performance Category ◽  
Spontaneous Circulation ◽  
Monocyte Subset ◽  
Pronounced Increase ◽  
Performance Category ◽  
Medical Intensive Care ◽  
Classical Monocytes ◽  
Intermediate Monocytes ◽  
Subset Distribution

Background: After successful cardiopulmonary resuscitation (CPR) with return of spontaneous circulation (ROSC), many patients show signs of an overactive immune activation. Monocytes are a heterogeneous cell population that can be distinguished into three subsets. The aim of this prospective, observational study was to analyse whether monocyte subset distribution is associated with mortality at 6 months in patients after cardiac arrest (CA). Methods: We included 53 patients admitted to our medical intensive care unit (ICU) after CA. Blood was taken on admission and after 72 hours and monocyte subset distribution was analysed by flow cytometry and distinguished into classical monocytes (CD14++CD16-), intermediate monocytes (CD14++CD16+CCR2+) and non-classical monocytes (CD14+CD16++CCR2-). Results: Median age was 64.5 (interquartile range (IQR) 49.8-74.3) years and 75.5% were male. Six-month mortality was 50.9% and survival with good neurological outcome was 37.7%. Monocyte subset distribution upon admission to the ICU did not differ according to survival. However, patients who died within 6 months showed a more pronounced increase in the pro-inflammatory subset of intermediate monocytes (8.3% (3.8-14.6)% vs. 4.1% (1.5-8.2)%; p=0.025), and a decrease of classical monocytes (87.5% (79.9-89.0)% vs. 90.8% (85.9-92.7)%; p=0.036) 72 hours after admission. In addition, intermediate monocytes were predictive of outcome independent of time to ROSC and witnessed cardiac arrest, and correlated with the cerebral performance category (CPC)-score at 6 months (R=0.32; p=0.043). Discussion: Monocyte subset distribution is associated with outcome in patients surviving a CA. The activation of the innate immune system may play a significant role in CA patients.

scholarly journals Monocyte subsets predict mortality after cardiac arrest

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
K.A Krychtiuk ◽  
M Lenz ◽  
B Richter ◽  
K Huber ◽  
J Wojta ◽  
...  
Keyword(s):  
Cardiac Arrest ◽  
Spontaneous Circulation ◽  
Strong Increase ◽  
Funding Source ◽  
Monocyte Subset ◽  
Male Mortality ◽  
National Budget ◽  
Classical Monocytes ◽  
Intermediate Monocytes ◽  
Subset Distribution

Abstract Background After successful cardiopulmonary resuscitation with return of spontaneous circulation (ROSC), many patients show signs of an overactive immune activation. Monocytes are a heterogenous cell population that can be distinguished into three subsets. Purpose The aim of this prospective, observational study was to analyze whether monocyte subset distribution is associated with mortality at 6 months in patients after cardiac arrest. Methods We included 53 patients admitted to our medical ICU after cardiac arrest. Blood was taken on admission and monocyte subset distribution was analyzed by flow cytometry and distinguished into classical monocytes (CM; CD14++CD16-), intermediate monocytes (IM; CD14++CD16+CCR2+) and non-classical monocytes (NCM; CD14+CD16++CCR2-). Results Median age was 64.5 (IQR 49.8–74.3) years and 75.5% of patients were male. Mortality at 6 months was 50.9% and survival with good neurological outcome was 37.7%. Of interest, monocyte subset distribution upon admission to the ICU did not differ according to survival. However, patients that died within 6 months showed a strong increase in the pro-inflammatory subset of intermediate monocytes (8.3% (3.8–14.6)% vs. 4.1% (1.5–8.2)%; p=0.025), and a decrease of classical monocytes (87.5% (79.9–89.0)% vs. 90.8% (85.9–92.7)%; p=0.036) 72 hours after admission. In addition, intermediate monocytes were predictive of outcome independent of initial rhythm and time to ROSC and correlated with the CPC-score at 6 months (R=0.32; p=0.043). Discussion Monocyte subset distribution is associated with outcome in patients surviving a cardiac arrest. This suggests that activation of the innate immune system may play a significant role in patient outcome after cardiac arrest. Funding Acknowledgement Type of funding source: Public grant(s) – National budget only. Main funding source(s): FWF - Fonds zur Förderung der wissenschaftlichen Forschung

scholarly journals (A152) Comparison of Load Distributing Band and Standard Cardiopulmonary Resuscitation in Patients Presenting with Cardiac Arrest to Emergency Department

2011 ◽  
Vol 26 (S1) ◽  
pp. s43-s43
Author(s):  
M.E. Ong ◽  
P. Sultana ◽  
S. Fook-Chong ◽  
A. Annitha ◽  
S.H. Ang ◽  
...  
Keyword(s):  
Cardiac Arrest ◽  
Cardiopulmonary Resuscitation ◽  
Hospital Admission ◽  
Hospital Discharge ◽  
Cerebral Performance Category ◽  
Spontaneous Circulation ◽  
Secondary Outcome ◽  
Number Needed To Treat ◽  
Performance Category ◽  
Traumatic Cardiac Arrest

ObjectiveTo compare resuscitation outcomes before and after switching from manual cardiopulmonary resuscitation (CPR) to load-distributing band (LDB) CPR in a multi-center Emergency Departments (ED) trial.MethodsThis is a phased, prospective cohort evaluation with intention-to-treat analysis of adults with non-traumatic cardiac arrest. The intervention is change in the system from manual CPR to LDB-CPR at two Urban EDs. The main outcome measure is survival to hospital discharge, with secondary outcome measures of return of spontaneous circulation (ROSC), survival to hospital admission and neurological outcome at discharge.ResultsA total of 1,011 patients were included in the study, with 459 in the manual CPR phase (January 01, 2004, to August 24, 2007) and 552 patients in the LDB-CPR phase (August 16, 2007, to December 31, 2009). In the LDB phase, the LDB device was applied in 454 patients (82.3%). Patients in the manual CPR and LDB-CPR phases were comparable for mean age, gender and ethnicity. Rates for ROSC were comparable with LDB-CPR (manual 22.4% vs. LDB 35.3%; adjusted odds ratio [OR], 1.07; 95% confidence interval [CI], 0.63-1.83). Survival to hospital admission was increased, Manual 14.2% vs. LDB 19.7%; adjusted OR, 2.50; 95% CI, 1.05-6.00. Survival to hospital discharge was increased Manual 1.3% vs. LDB 3.3%; adjusted OR, 3.99; 95% CI, 1.06-15.02. The number of survivors with Cerebral Performance Category 1 (good) (Manual 1 vs. LDB 12, p < 0.01) and Overall Performance Category 1 (good) (Manual 1 vs. LDB 10, p < 0.01) was also increased. The Number Needed to Treat (NNT) for 1 survivor was 52 (95% CI, 26-1000).ConclusionA resuscitation strategy using LDB-CPR in an ED environment was associated with improved survival to admission and discharge in adults with non-traumatic cardiac arrest.

scholarly journals Post-resuscitation partial pressure of arterial carbon dioxide and outcome in patients with out-of-hospital cardiac arrest: a multicenter retrospective cohort study

2021 ◽  
Author(s):  
Nobunaga Okada ◽  
Tasuku Matsuyama ◽  
Yohei Okada ◽  
Asami Okada ◽  
Kenji Kandori ◽  
...  
Keyword(s):  
Cardiac Arrest ◽  
Neurological Outcome ◽  
Cerebral Performance Category ◽  
Multivariate Logistic Regression Analysis ◽  
Spontaneous Circulation ◽  
Performance Category ◽  
Neurological Outcomes ◽  
Significant Difference ◽  
Poor Neurological Outcome ◽  
Hospital Cardiac Arrest

Abstract We aimed to estimate the association between PaCO2 level in the patient after out-of-hospital cardiac arrest (OHCA) resuscitation with patient outcome based on a multicenter prospective cohort registry in Japan between June 2014 and December 2015.Based on the PaCO2 within 24-h after return of spontaneous circulation (ROSC), patients were divided into six groups as follow; severe hypocapnia (<25mmHg), mild hypocapnia (25–35mmHg,), normocapnia (35–45mmHg), mild hypercapnia (45–55mmHg), severe hypercapnia (>55mmHg), exposure to both hypocapnia and hypercapnia. Multivariate logistic regression analysis was conducted to calculate the adjusted odds ratios (aORs) and 95% confidence interval (CI) for the 1-month poor neurological outcome (Cerebral Performance Category ≥3). Among the 13491 OHCA patients, 607 were included. Severe hypocapnia, mild hypocapnia, severe hypercapnia, and exposure to both hypocapnia and hypercapnia were associated with a higher rate of 1-month poor neurological outcome compared with mild hypercapnia (aOR 6.68 [95% CI 2.16–20.67], 2.56 [1.30–5.04], 2.62 [1.06–6.47], 5.63 [2.21–14.34]; respectively). There was no significant difference between the outcome of patients with normocapnia and mild hypercapnia. In conclusion, maintaining normocapnia and mild hypercapnia during the 24-h after ROSC was associated with better neurological outcomes than other PaCO2 abnormalities in this study.

Abstract 13013: Survival After In-Hospital Cardiopulmonary Resuscitation for Cardiac Arrest in Patients With COVID-19: An Updated Meta-Analysis

Circulation ◽  
2021 ◽  
Vol 144 (Suppl_2) ◽  
Author(s):  
Archana Pattupara ◽  
Devika Aggarwal ◽  
Kirtipal S Bhatia ◽  
Olga Gomez-Rojas ◽  
vardhmaan jain ◽  
...  
Keyword(s):  
Cardiac Arrest ◽  
Hospital Discharge ◽  
Meta Analysis ◽  
Cerebral Performance Category ◽  
Spontaneous Circulation ◽  
Neurological Recovery ◽  
Term Survival ◽  
Performance Category ◽  
Initial Rhythm ◽  
Hospital Cardiac Arrest

Introduction: Several small studies have reported variable outcomes following in-hospital cardiac arrest (IHCA) in patients with COVID-19. A clear estimate is important in prognostication and guiding resuscitation efforts and policies for these patients. Methods: A search of PubMed, Embase, and Scopus databases was conducted to identify studies reporting outcomes after IHCA in adult patients with confirmed COVID-19. The cumulative characteristics of the patients were described. The primary outcome studied was survival at 30 days or at hospital discharge (short term survival). Additional outcomes of interest were proportional prevalence of the initial rhythm at arrest, return of spontaneous circulation (ROSC), and neurological recovery (defined as Cerebral Performance Category Score of 1-2 ). Metanalysis of proportions was performed utilizing the Metaprop command. A random effects model was chosen to account for interstudy variance. Results: A total of 13 eligible studies were identified and included in the analyses. Out of all the hospitalized patients with COVID-19, 1,618 underwent advanced cardiac resuscitation after an IHCA. Patients who had a cardiac arrest had a median age between 50-69 years. IHCA occurred predominantly in men, and in the ICU setting. Shockable rhythms were identified in 8% (95% CI 5-10%, I2; 56%) and non-shockable rhythms in 89% (95% CI 85-94% I2; 84%) of patients (Fig. 1a). ROSC was achieved in 40% (95% CI 31-48% I2; 90%) (Fig. 1b). Only 7 % ( 95% CI 3-12% I2; 86%) of patients survived at 30 days/hospital discharge (Fig. 1c). Neurological recovery was seen in 5% (95% CI 3-9% I2; 67%) of patients who suffered a IHCA (Fig. 1d). Conclusions: Our meta-analysis demonstrates the majority of the cardiac arrests in patients with COVID-19 have non-shockable rhythms. Survival rate in these patients is low, and neurological recovery is unfavorable. This study provides further insight in guiding resuscitation efforts in these patients.

Abstract 111: Impact of Time to Return of Spontaneous Circulation on Neurologically Intact Survival in Patients With Out-of-Hospital Cardiac Arrest According to Age: Evidence From a Large-Scale Registry in Japan

Circulation ◽  
2018 ◽  
Vol 138 (Suppl_2) ◽  
Author(s):  
Akira Funada ◽  
Yoshikazu Goto ◽  
Hayato Tada ◽  
Masaya Shimojima ◽  
Hirofumi Okada ◽  
...  
Keyword(s):  
Cardiac Arrest ◽  
Large Scale ◽  
Cerebral Performance Category ◽  
Spontaneous Circulation ◽  
Performance Category ◽  
Return Of Spontaneous Circulation ◽  
The Impact ◽  
The Relationship ◽  
Neurologically Intact ◽  
Hospital Cardiac Arrest

Introduction: Time to return of spontaneous circulation (ROSC) is a more important predictor of neurologically intact survival than the presence of ROSC in patients with out-of-hospital cardiac arrest (OHCA). However, the differences in the relationship between time to ROSC and neurologically intact survival in patients with OHCA based on age is unclear. Hypothesis: We hypothesized that the impact of time to ROSC on neurologically intact survival differs according to age. Methods: We analyzed the data of 34,905 patients with OHCA (age ≥18 years) who exhibited prehospital ROSC from the prospectively recorded all-Japan OHCA registry (2011-2014). The primary outcome was neurologically intact survival at 1 month after OHCA (cerebral performance category [CPC] 1 or 2). Time to ROSC was defined as the interval from the initiation of cardiopulmonary resuscitation (CPR) by emergency medical service (EMS) providers to the achievement of ROSC. We categorized time to ROSC by every 4-min interval (2 cycles of CPR) from 1 to 32 min and ≥33 min, and age into 4 groups: 18-64, 65-74, 75-89, and ≥90 years. Results: The overall CPC 1-2 rate was 21.1% (7,353/34,905). Increasing time to ROSC (per min) was negatively associated with CPC 1-2 (adjusted odds ratio, 0.91; 95% confidence interval, 0.90-0.91). The CPC 1-2 rates decreased as time to ROSC increased in each age group: from 58.8% (1,247/2,122) in 1-4 min to 2.8% (7/246) in ≥33 min for patients aged 18-64 years, from 51.1% (721/1,410) in 1-4 min to 1.6% (4/244) in ≥33 min for 65-74 years, from 37.3% (765/2,051) in 1-4 min to 0.7% (4/539) in 29-32 min for 75-89 years, and from 23.4% (92/393) in 1-4 min to 0.2% (1/481) in 17-20 min for ≥90 years (all p for trend <0.001). Conclusions: The CPC 1-2 rates of patients aged 18-64 and 65-74 years were above the 1% futility rate when prehospital ROSC was achieved after prolonged CPR, ≥33 min from initiation by EMS providers. However, the CPC 1-2 rates were below the 1% futility rate when prehospital ROSC was achieved ≥29 min and ≥17 min for patients aged 75-89 years and ≥90 years, respectively.

Abstract 204: Conventional vs. Compression-Only Cardiopulmonary Resuscitation for Geriatric Out-of-Hospital Cardiac Arrest

Circulation ◽  
2018 ◽  
Vol 138 (Suppl_2) ◽  
Author(s):  
Hiroki Ueyama ◽  
Yosuke Homma ◽  
Hiroyasu Shimizu ◽  
Tetsuya Inoue ◽  
Hiraku Funakoshi
Keyword(s):  
Cardiac Arrest ◽  
Cardiopulmonary Resuscitation ◽  
Scale Score ◽  
Cerebral Performance Category ◽  
Spontaneous Circulation ◽  
Category Scale ◽  
Performance Category ◽  
Adjusted Analysis ◽  
Significant Difference ◽  
Hospital Cardiac Arrest

Introduction: Compression-only cardiopulmonary resuscitation (CPR) and conventional CPR (30:2, chest compression and rescue breathing) performed by bystanders are known to have similar outcomes in adults. This study aimed to investigate if this difference is applicable in geriatric populations as well. Methods: We conducted a prospective observational study using the All-Japan Utstein Registry to enroll geriatric patients (≥75 years) who experienced out-of-hospital cardiac arrest that was witnessed by bystanders in Japan from January 1, 2009 to December 31, 2013. The primary outcome was favorable neurological function 1 month after the event, which was defined as a Cerebral Performance Category Scale score of 1 or 2. The secondary outcomes were return of spontaneous circulation (ROSC), 1-month survival, and favorable overall function 1 month after the event, which was defined as an Overall Performance Category Scale score of 1 or 2. Outcomes of compression-only CPR and conventional CPR were compared using multivariable logistic regression analyses. Results: Of the 58,072 enrolled patients, 13,248 (22.8%) received conventional CPR whereas 44,824 (77.2%) received compression-only CPR. Favorable neurological outcomes were achieved in 708 (5.3%) patients receiving CPR and 1799 (4.0%) patients receiving compression-only CPR. A crude analysis of neurologically favorable survival revealed superiority of conventional CPR [odds ratio (OR), 1.35; 95% confidence interval (CI), 1.24–1.48; P < 0.001]], but it was no longer statistically significant after multivariable adjustment (OR, 1.09; 95% CI, 0.93–1.27; P = 0.29). Similarly, multivariable adjusted analysis of favorable overall function survival showed no significant difference (OR, 1.08; 95% CI, 0.92–1.26; P = 0.38) between conventional and compression-only CPR. Conventional CPR demonstrated better outcomes in multivariable adjusted analysis of ROSC and 1 month survival (OR, 1.30; 95% CI, 1.22–1.40; P < 0.001 and OR, 1.13. 95% CI, 1.04–1.23; P = 0.003, respectively). Conclusions: The superiority of conventional CPR in geriatric populations was not proven. Thus, we conclude that compression-only CPR is an adequate means of resuscitation in geriatric populations.

scholarly journals Impact of the cardiopulmonary resuscitation-related injuries on the prognosis after cardiac arrest

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
C Merino Argos ◽  
I Marco Clement ◽  
S.O Rosillo Rodriguez ◽  
L Martin Polo ◽  
E Arbas Redondo ◽  
...  
Keyword(s):  
Cardiac Arrest ◽  
Cardiopulmonary Resuscitation ◽  
Cerebral Performance Category ◽  
University Hospital ◽  
Temperature Management ◽  
Performance Category ◽  
Neurological Outcomes ◽  
Cardiac Care Unit ◽  
Sternal Fractures

Abstract Background Cardiopulmonary resuscitation (CPR) manoeuvres involve vigorous compressions with the proper depth and rate in order to keep sufficient perfusion to organs, especially the brain. Accordingly, high incidences of CPR-related injuries (CPR-RI) have been observed in survivors after cardiac arrest (CA). Purpose To analyse whether CPR-related injuries have an impact on the survival and neurological outcomes of comatose survivors after CA. Methods Observational prospective database of consecutive patients (pts) admitted to the acute cardiac care unit of a tertiary university hospital after in-hospital and out-of-hospital CA (IHCA and OHCA) treated with targeted temperature management (TTM 32–34°) from August 2006 to December 2019. CPR-RI were diagnosed by reviewing medical records and analysing image studies during hospitalization. Results A total of 498 pts were included; mean age was 62.7±14.5 years and 393 (78.9%) were men. We found a total of 145 CPR-RI in 109 (21.9%) pts: 79 rib fractures, 20 sternal fractures, 5 hepatic, 5 gastrointestinal, 3 spleen, 1 kidney, 26 lung and 6 heart injuries. Demographic characteristics and cardiovascular risk factors did not differ between the non-CPR-RI group and CPR-RI group. Also, we did not find differences in CA features (Table 1). Survival at discharge was higher in the CPR-RI group [74 (67.8%) vs 188 (48.3%); p&lt;0.001]. Moreover, Cerebral Performance Category (CPC) 1–2 within a 3-month follow-up was significantly higher in the CPR-RI group [(71 (65.1%) vs 168 (43.2%); p&lt;0.001; Figure 1]. Finally, pts who recieved blood transfusions were proportionally higher in the CPR-RI group [34 (32.1%) vs 65 (16.7%)]; p=0.004). Conclusions In our cohort, the presence of CPR-RI was associated with higher survival at discharge and better neurological outcomes during follow-up. Figure 1 Funding Acknowledgement Type of funding source: None

Abstract 115: One-Year Outcomes in Individual Domains of the Cerebral Performance Category Extended

Circulation ◽  
2018 ◽  
Vol 138 (Suppl_2) ◽  
Author(s):  
Katharyn L Flickinger ◽  
Melissa J Repine ◽  
Stephany Jaramillo ◽  
Allison C Koller ◽  
Margo Holm ◽  
...  
Keyword(s):  
Cardiac Arrest ◽  
Return To Work ◽  
Short Term Memory ◽  
Demographic Data ◽  
Cerebral Performance Category ◽  
Logical Thinking ◽  
Short Term ◽  
Performance Category ◽  
Term Memory

Introduction: Cognitive and physical impairments are common in cardiac arrest survivors. Global measures including the Modified Rankin Scale (mRS), Cerebral Performance Category (CPC) and the 10-domain CPC-Extended (CPC-E) tend to improve over 1 year. The CPC-E is scored from 1-5 with higher scores signifying greater impairment. However, with the CPC-E, individual functional domains (alertness, logical thinking, attention, motor skills, short-term memory, basic and complex activities of daily living (ADL), mood, fatigue, and return to work) may recover at different rates. Hypothesis: We hypothesized that patients would have recovery in all domains of the CPC-E at 1 year after index cardiac arrest. Methods: A prospective cohort study of cardiac arrest survivors was conducted between 2/1/16 and 5/31/17. Chart review was done for baseline demographic data. Outcome measures including mRS, CPC, and CPC-E scores were assessed at discharge, 3 months, 6 months, and 1 year. We defined recovery of a CPC-E domain when >90% of patients had scores of 1-2 in that domain. Results: Of 71 subjects, 35 completed the CPC-E at discharge, 35 at 3 months, 25 at 6 months and 31 at 1 year. The most common reasons for exclusion were patient declined or were lost to follow up. The majority (N=37; 52%) were female, with a mean (SD) age of 58(17) years. Most arrests occurred out of hospital (N= 49; 69%), 27 (38%) had a shockable rhythm and the majority (N=37; 54%) were discharged home. CPC-E domains of alertness (N=35, 100%) logical thinking (N=35; 100%), and attention (N=33; 94%) recovered by hospital discharge. BADLs were recovered by 3 months (N=33; 94%). The majority of patients (N=24;77%) experienced slight-to-no disability or symptoms (mRS 0-2 / CPC 1-2) at 1 year follow up. CPC-E short term memory (67%), motor (87%), mood (87%), fatigue (13%), complex ADL (74%), and return to work (55%) did not recover fully by 1 year. Conclusions: In survivors of cardiac arrest, CPC-E domains of alertness, logical thinking, and attention recover rapidly, while domains of short term memory, motor, mood, fatigue, complex ADL and ability to return to work are chronically impaired 1 year after arrest. Interventions to improve recovery in these domains are needed.

Abstract 240: Are the Same Resuscitation Protocols Needed for Highly Aged Victims With Out-of-Hospital Cardiac Arrest as Middle or Younger Aged?

Circulation ◽  
2018 ◽  
Vol 138 (Suppl_2) ◽  
Author(s):  
Hiroyuki Hanada ◽  
Yoshio Tahara ◽  
Satoshi Yasuda ◽  
Teruo Noguchi ◽  
Kunihiro Nishimura ◽  
...  
Keyword(s):  
Cardiac Arrest ◽  
Total Population ◽  
Cerebral Performance Category ◽  
Population Based ◽  
Aged Patients ◽  
Performance Category ◽  
Aging Society ◽  
Shockable Rhythm ◽  
Activity Of Daily Life ◽  
Hospital Cardiac Arrest

Backgrounds: The population of elderly people aged 65 years or older in 2014 is 33 million, and the aging rate (proportion of the total population) is 26.0% in Japan. Victims facing to out of hospital cardiac arrest (OHCA) are getting older and older. Emergency medical system (EMS) in Japan must do the same resuscitation protocols once called to the patient with OHCA, even when he or she is very old and activity of daily life is very low. We need to clarify whether same resuscitation protocols are required to very highly aged patients with OHCA or not. Methods and Results: From January 2005 through December 2014, we conducted a prospective, population-based, observational study involving the consecutive patients across Japan who had OHCA (n= 1,299,784). The percentage of patients with OHCA aged more than 80 years old was increasing from 37.1% in 2005 to 47.8% in 2014 by 1% each year. Survival at one month after OHCA with cerebral performance category (CPC) scale 1 or 2 were 4,368 out of total 318,590 OHCA (1.4%) in 80’s, 1043 out of 126,546 (0.8%) in 90’s, and 35 out of 5,544 (0.6%) in aged more than 100 (from 100 to 114). Survival at one month after OHCA with CPC scale 1 or 2 was 11.084 out of 234,366 (4.7%) in 50- 60’s. Patients with witnessed OHCA with shockable rhythm and by-stander CPR survived to CPC 1 or 2 at one month after OHCA were 8.0% in 80’s, 4.1% in 90’s, 0 in aged more than 100, and 22.2% in 50-60’s respectably. Conclusion: Number of survivors with CPC 1 or 2 were very few in patients with OHCA aged more than 80 years old, but still existed. Although the same resuscitation protocols are needed for highly aged victims with OHCA, another system which arrow EMS to stop resuscitation should be established in the highly aging society.

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