Evolution of Survival in Cardiac Arrest with Age in Elderly Patients: Is Resuscitation a Dead End?. Segal, N., di Pompéo, C., Escutnaire, J., Wiel, E., Dumont, C., Castra, L., Tazarourte, K., El Khoury, C., Gueugniaud, P., Hubert, H., & GR-RéAC The Journal of Emergency Medicine, 54(3):295–301, 2018.
doi  abstract   bibtex   
BACKGROUND: Even if age is not considered the key prognostic factor for survival in cardiac arrest (CA), some studies question whether cardiopulmonary resuscitation (CPR) in the elderly could be futile. OBJECTIVE: The aim of this study was to describe differences in out-of-hospital CA survival rates according to age stratification based on the French National CA registry (RéAC). The second objective was to analyze the differences in resuscitation interventions according to age. METHODS: We performed a retrospective cohort study based on data extracted from the RéAC. All 18,249 elderly patients (\textgreater65 years old) with non-traumatic CA recorded between July 2011 and March 2015 were included. Patients' ages were stratified into 5-year increments. RESULTS: Cardiopulmonary resuscitation (CPR) was started significantly more often in younger patients (p = 0.019). Ventilation and automated external defibrillation by bystanders were started without any difference between age subgroups (p = 0.147 and p = 0.123, respectively). No difference in terms of rate of external chest compressions or ventilation initiation was found between the subgroups (p = 0.357 and p = 0.131, respectively). Advanced cardiac life support was started significantly more often in younger patients (p = 0.023). Total CPR duration, return of spontaneous circulation, and survival at hospital admission and at 30 days or hospital discharge decreased significantly with age (p \textless 10-3). The survival decrease was linear, with a loss of 3% survival chances each 5-year interval. CONCLUSIONS: This study found that survival in older persons decreased linearly by 3% every 5 years. However, this diminished rate of survival could be the consequence of a shorter duration and less advanced life support.
@article{segal_evolution_2018,
	title = {Evolution of {Survival} in {Cardiac} {Arrest} with {Age} in {Elderly} {Patients}: {Is} {Resuscitation} a {Dead} {End}?},
	volume = {54},
	issn = {0736-4679},
	shorttitle = {Evolution of {Survival} in {Cardiac} {Arrest} with {Age} in {Elderly} {Patients}},
	doi = {10.1016/j.jemermed.2017.11.018},
	abstract = {BACKGROUND: Even if age is not considered the key prognostic factor for survival in cardiac arrest (CA), some studies question whether cardiopulmonary resuscitation (CPR) in the elderly could be futile.
OBJECTIVE: The aim of this study was to describe differences in out-of-hospital CA survival rates according to age stratification based on the French National CA registry (RéAC). The second objective was to analyze the differences in resuscitation interventions according to age.
METHODS: We performed a retrospective cohort study based on data extracted from the RéAC. All 18,249 elderly patients ({\textgreater}65 years old) with non-traumatic CA recorded between July 2011 and March 2015 were included. Patients' ages were stratified into 5-year increments.
RESULTS: Cardiopulmonary resuscitation (CPR) was started significantly more often in younger patients (p = 0.019). Ventilation and automated external defibrillation by bystanders were started without any difference between age subgroups (p = 0.147 and p = 0.123, respectively). No difference in terms of rate of external chest compressions or ventilation initiation was found between the subgroups (p = 0.357 and p = 0.131, respectively). Advanced cardiac life support was started significantly more often in younger patients (p = 0.023). Total CPR duration, return of spontaneous circulation, and survival at hospital admission and at 30 days or hospital discharge decreased significantly with age (p {\textless} 10-3). The survival decrease was linear, with a loss of 3\% survival chances each 5-year interval.
CONCLUSIONS: This study found that survival in older persons decreased linearly by 3\% every 5 years. However, this diminished rate of survival could be the consequence of a shorter duration and less advanced life support.},
	language = {eng},
	number = {3},
	journal = {The Journal of Emergency Medicine},
	author = {Segal, Nicolas and di Pompéo, Christophe and Escutnaire, Joséphine and Wiel, Eric and Dumont, Cyrielle and Castra, Laurent and Tazarourte, Karim and El Khoury, Carlos and Gueugniaud, Pierre-Yves and Hubert, Hervé and {GR-RéAC}},
	year = {2018},
	pmid = {29273461},
	keywords = {Age Factors, Aged, Aged, 80 and over, Cohort Studies, Female, France, Humans, Linear Models, Male, Out-of-Hospital Cardiac Arrest, Registries, Resuscitation, Retrospective Studies, Survival Analysis, Time Factors, United States, aged, aged 80 and over, cardiac arrest, cardiopulmonary resuscitation, elderly, resuscitation},
	pages = {295--301},
}

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