scholarly journals Long-term outcome of elderly out-of-hospital cardiac arrest survivors as compared with their younger counterparts and the general population

2018 ◽  
Vol 12 (12) ◽  
pp. 341-349 ◽  
Author(s):  
Bart Hiemstra ◽  
Remco Bergman ◽  
Anthony R. Absalom ◽  
Joukje van der Naalt ◽  
Pim van der Harst ◽  
...  
Keyword(s):  
Cardiac Arrest ◽  
General Population ◽  
Elderly Patients ◽  
The Elderly ◽  
Term Outcome ◽  
Term Survival ◽  
Long Term Outcome ◽  
Younger Patients ◽  
Hospital Cardiac Arrest

Background: Over the past decade, prehospital and in-hospital treatment for out-of-hospital cardiac arrest (OHCA) has improved considerably. There are sparse data on the long-term outcome, especially in elderly patients. We studied whether elderly patients benefit to the same extent compared with younger patients and at long-term follow up as compared with the general population. Methods: Between 2001 and 2010, data from all patients presented to our hospital after OHCA were recorded. Elderly patients (⩾75 years) were compared with younger patients. Neurological outcome was classified as cerebral performance category (CPC) at hospital discharge and long-term survival was compared with younger patients and predicted survival rates of the general population. Results: Of the 810 patients admitted after OHCA, a total of 551 patients (68%) achieved return of spontaneous circulation, including 125 (23%) elderly patients with a mean age of 81 ± 5 years. In-hospital survival was lower in elderly patients compared with younger patients with rates of 33% versus 57% ( p < 0.001). A CPC of 1 was present in 73% of the elderly patients versus 86% of the younger patients ( p = 0.031). In 7.3% of the elderly patients, a CPC >2 was observed versus 2.5% of their younger counterparts ( p = 0.103). Elderly patients had a median survival of 6.5 [95% confidence interval (CI) 2.0–7.9] years compared with 7.7 (95% CI 7.5–7.9) years of the general population ( p = 0.019). Conclusions: The survival rate after OHCA in elderly patients is approximately half that of younger patients. Elderly patients who survive to discharge frequently have favorable neurological outcomes and a long-term survival that approximates that of the general population.

P2828Survival after an out-of-hospital cardiac arrest decrease over time in all Utstein categories. The importance of a long follow-up

2019 ◽  
Vol 40 (Supplement_1) ◽  
Author(s):  
E Baldi ◽  
S Buratti ◽  
E Contri ◽  
S Canevari ◽  
S Molinari ◽  
...  
Keyword(s):  
Cardiac Arrest ◽  
Term Outcome ◽  
Term Survival ◽  
Long Term Outcome ◽  
Shockable Rhythm ◽  
The People ◽  
Hospital Cardiac Arrest ◽  
Over Time

Abstract Background Survival beyond 1-month after an out-of-hospital cardiac arrest (OHCA) is still considered a challenge for OHCA registries and it is often unexplored. However, a longer follow-up could help to better comprehend the long-term issues of OHCA survivors. Purpose Our aim was to evaluate the long-term outcome after OHCA via an Utstein-based cardiac arrest registry with a long follow-up (up to 5 years). Methods We enrolled all the people with an OHCA of any aetiology in our Province (about 55ehz748.1138 inhabitants in northern Italy) in whom CPR was attempted. The primary endpoint was the survival at 1 month, and the secondary endpoints were the survival at 6 months and then every year until 5 years after OHCA. Results In the first 45 months (October 2014–June 2018) 1774 resuscitation attempts for confirmed OHCAs were enrolled. Baseline characteristics: male 59.7%; mean age of 73.4±16 years; mean EMS response time was 11:31±5:09 mins; home location 78.8%; bystander-witnessed events were 56.1%; EMS witnessed event 15.6%; bystander CPR 39.5%; AED use before EMS arrival 2.5%; medical etiology 93%; first shockable rhythm 18.2% (90.7% VF, 2.5% VT without pulse, 6.8% AED shockable). When considering survival from the event (Figure 1 – left panel), survival was significantly higher for shockable Utstein categories (p<0.001). Considering only those patients discharged alive (Figure 1 – right panel) long term survival was significantly higher (p<0.01) once again for shockable rhythms. Interestingly, in this category survival continued to decrease over time ranging about from 90% in the first year to about 80% at four years. Figure 1 Conclusions Our results demonstrated that survival after OHCA can change over the time in all the Utstein categories, so we believe that a longer follow-up should be encouraged by next Utstein style revision.

Short- and Long-Term Outcome in Elderly Patients After Out-of-Hospital Cardiac Arrest

2014 ◽  
Vol 42 (11) ◽  
pp. 2350-2357 ◽  
Author(s):  
David Grimaldi ◽  
Florence Dumas ◽  
Marie-Cécile Perier ◽  
Julien Charpentier ◽  
Olivier Varenne ◽  
...  
Keyword(s):  
Cardiac Arrest ◽  
Elderly Patients ◽  
Term Outcome ◽  
Long Term Outcome ◽  
Short And Long Term ◽  
Hospital Cardiac Arrest

scholarly journals Long-term outcome of patients after out-of-hospital cardiac arrest in relation to treatment: a single-centre study

2015 ◽  
Vol 5 (4) ◽  
pp. 328-338 ◽  
Author(s):  
Remco Bergman ◽  
Bart Hiemstra ◽  
Wybe Nieuwland ◽  
Eric Lipsic ◽  
Anthony Absalom ◽  
...  
Keyword(s):  
Cardiac Arrest ◽  
Single Centre ◽  
Term Outcome ◽  
Long Term Outcome ◽  
Centre Study ◽  
Single Centre Study ◽  
Hospital Cardiac Arrest

scholarly journals Surgery for meningioma in the elderly and long-term survival: comparison with an age- and sex-matched general population and with younger patients

2017 ◽  
Vol 126 (4) ◽  
pp. 1201-1211 ◽  
Author(s):  
Benjamin Brokinkel ◽  
Markus Holling ◽  
Dorothee Cäcilia Spille ◽  
Katharina Heß ◽  
Cristina Sauerland ◽  
...  
Keyword(s):  
General Population ◽  
Elderly Patients ◽  
Older Patients ◽  
The Elderly ◽  
Spinal Tumors ◽  
Subtotal Resection ◽  
High Grade ◽  
Younger Patients ◽  
Age And Sex

OBJECTIVE The purpose of this study was to compare long-term prognosis after meningioma surgery in elderly and younger patients as well as to compare survival of elderly patients with surgically treated meningioma to survival rates for the general population. METHODS Five hundred meningioma patients (median follow-up 90 months) who underwent surgery between 1994 and 2009 were subdivided into “elderly” (age ≥ 65 years, n = 162) and “younger” (age < 65 years, n = 338) groups for uni- and multivariate analyses. Mortality was compared with rates for the age- and sex-matched general population. RESULTS The median age at diagnosis was 71 in the elderly group and 51 years in the younger group. Sex, intracranial tumor location, grade of resection, radiotherapy, and histopathological subtypes were similar in the 2 groups. High-grade (WHO Grades II and III) and spinal tumors were more common in older patients than in younger patients (15% vs 8%, p = 0.017, and 12% vs 4%, p = 0.001, respectively). The progression-free interval (PFI) was similar in the 2 groups, whereas mortality at 3 months after surgery was higher and median overall survival (OS) was shorter in older patients (7%, 191 months) than in younger patients (1%, median not reached; HR 4.9, 95% CI 2.75–8.74; p < 0.001). Otherwise, the median OS in elderly patients did not differ from the anticipated general life expectancy (HR 1.03, 95% CI 0.70–1.50; p = 0.886). Within the older patient group, PFI was lower in patients with high-grade meningiomas (HR 24.74, 95% CI 4.23–144.66; p < 0.001) and after subtotal resection (HR 10.57, 95% CI 2.23–50.05; p = 0.003). Although extent of resection was independent of perioperative mortality, the median OS was longer after gross-total resection than after subtotal resection (HR 2.7, 95% CI 1.09–6.69; p = 0.032). CONCLUSIONS Elderly patients with surgically treated meningioma do not suffer from impaired survival compared with the age-matched general population, and their PFI is similar to that of younger meningioma patients. These data help mitigate fears concerning surgical treatment of elderly patients in an aging society.

scholarly journals Long-Term Outcome of Implanted Cardioverter Defibrillators in Survivors of Out-of-Hospital Cardiac Arrest of Cardiac Origin

2006 ◽  
Vol 70 (9) ◽  
pp. 1128-1132 ◽  
Author(s):  
Daigo Nagahara ◽  
Mamoru Hase ◽  
Kazufumi Tsuchihashi ◽  
Nobuaki Kokubu ◽  
Seiichiro Sakurai ◽  
...  
Keyword(s):  
Cardiac Arrest ◽  
Term Outcome ◽  
Long Term Outcome ◽  
Cardioverter Defibrillators ◽  
Hospital Cardiac Arrest

scholarly journals Early activation of the kynurenine pathway predicts early death and long-term outcome in patients resuscitated from out-of-hospital cardiac arrest

Resuscitation ◽  
2014 ◽  
Vol 85 ◽  
pp. S13
Author(s):  
Giuseppe Ristagno ◽  
Roberto Latini ◽  
Jukka Vaahersalo ◽  
Serge Masson ◽  
Jouni Kurola ◽  
...  
Keyword(s):  
Cardiac Arrest ◽  
Early Death ◽  
Kynurenine Pathway ◽  
Term Outcome ◽  
Long Term Outcome ◽  
Early Activation ◽  
Hospital Cardiac Arrest

Abstract 305: German Resuscitation Registry Influence of Age on Short and Long-Term Outcome After Out-of-Hospital Cardiac Arrest or Should We Resuscitate the Elderly?

Circulation ◽  
2018 ◽  
Vol 138 (Suppl_2) ◽  
Author(s):  
Stephan Seewald ◽  
Jan Wnent ◽  
Barbara Jakisch ◽  
Andreas Bohn ◽  
Matthias Fischer ◽  
...  
Keyword(s):  
Cardiac Arrest ◽  
Neurological Outcome ◽  
The Elderly ◽  
Good Neurological Outcome ◽  
Term Survival ◽  
Long Term Survival ◽  
Shockable Rhythm ◽  
Short And Long Term ◽  
Hospital Cardiac Arrest

Introduction: Cardiac arrest is a common event and one of the leading causes of death. Especially within the elderly judgment on if the treatment will be in favor of the patient is a major challenge for the medical team. We evaluated the influence of the age on short and long-term survival after out-of- hospital cardiac arrest (OHCA). Hypothesis: Elderly people survive an out-of-hospital cardiac arrest with good neurological outcome. Methods: For this purpose, we analyzed data of 24,686 out-of-hospital cardiac arrest patients prospectively registered between 2008 and 2017 within the German Resuscitation Registry (GRR). The data records were divided according to different age groups and within the age group after shockable and non-shockable rhythms. The data sets were examined with regard to short and long-term survival. Short term survival was measured by expected and observed return-of-spontaneous circulation based on the RACA-score. The RACA-score is a previously published score to predict ROSC based on readily available variables after arrival of the emergency medical service (EMS) on scene. Long-term survival was differentiated in 24-hour survival, 30-day survival and hospital discharge with good neurological outcome (Cerebral Performance Category 1 and 2). Results: (Table 1) Conclusions: Our data shows that shockable rhythm and younger age are important factors of good neurological outcome after OHCA. Nevertheless, the few cases with shockable rhythms (411 out of 3227) in the elderly (>85 years) showed a favorable neurological outcome in 12.2% (77,2% of all patients with hospital discharge). In the non-shockable group 1.4% (58,3%) of the >85 year old had a good outcome. Data show that a resuscitation attempt in the elderly is not futile, especially if a shockable rhythm is detected. Further studies are necessary to maintain this decision.

MICROVASCULAR DECOMPRESSION FOR TRIGEMINAL NEURALGIA IN THE ELDERLY

Neurosurgery ◽  
2009 ◽  
Vol 65 (3) ◽  
pp. 477-482 ◽  
Author(s):  
Thomas Günther ◽  
Venelin M. Gerganov ◽  
Lennart Stieglitz ◽  
Wolf Ludemann ◽  
Amir Samii ◽  
...  
Keyword(s):  
Pain Relief ◽  
Trigeminal Neuralgia ◽  
Microvascular Decompression ◽  
The Elderly ◽  
Safe Procedure ◽  
Term Outcome ◽  
Long Term Outcome ◽  
Younger Patients ◽  
The Mean

Abstract OBJECTIVE Multiple studies have proved that microvascular decompression (MVD) is the treatment of choice in cases of medically refractory trigeminal neuralgia (TN). In the elderly, however, the surgical risks related to MVD are assumed to be unacceptably high and various alternative therapies have been proposed. We evaluated the outcomes of MVD in patients aged older than 65 years of age and compared them with the outcomes in a matched group of younger patients. The focus was on procedure-related morbidity rate and long-term outcome. METHODS This was a retrospective study of 112 patients with TN operated on consecutively over 22 years. The main outcome measures were immediate and long-term postoperative pain relief and neurological status, especially function of trigeminal, facial, and cochlear nerves, as well as surgical complications. A questionnaire was used to assess long-term outcome: pain relief, duration of a pain-free period, need for pain medications, time to recurrence, pain severity, and need for additional treatment. RESULTS The mean age was 70.35 years. The second and third branches of the trigeminal nerve were most frequently affected (37.3%). The mean follow-up period was 90 months (range, 48–295 months). Seventy-five percent of the patients were completely pain free, 11% were never pain free, and 14% experienced recurrences. No statistically significant differences existed in the outcome between the younger and older patient groups. Postoperative morbidity included trigeminal hypesthesia in 6.25%, hypacusis in 5.4%, and complete hearing loss, vertigo, and partial facial nerve palsy in 0.89% each. Cerebrospinal fluid leak and meningitis occurred in 1 patient each. There were no mortalities in both groups. CONCLUSION MVD for TN is a safe procedure even in the elderly. The risk of serious morbidity or mortality is similar to that in younger patients. Furthermore, no significant differences in short- and long-term outcome were found. Thus, MVD is the treatment of choice in patients with medically refractory TN, unless their general condition prohibits it.

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