Old age does not negate good cerebral outcome after cardiopulmonary resuscitation

Authors:
  • PSPeter Safar
    Peter Safar
  • KSKim Sutton-Tyrrell
    Kim Sutton-Tyrrell
  • NANorman S. Abramson
    Norman S. Abramson

Abstract
To assess survival after cardiac arrest and to determine whether age is an independent determinant of late mortality or poor neurologic outcome. Analyses using results of Brain Resuscitation Clinical Trial I (1979 to 1984) and Brain Resuscitation Clinical Trial II (1984 to 1989), two randomized, double-blind studies of outcome following cardiac arrest. A multicenter study in 12 acute care hospitals in nine countries (Brain Resuscitation Clinical Trial I), and 24 hospitals in eight countries (Brain Resuscitation Clinical Trial II). A total of 774 patients who were initially comatose after successful resuscitation from cardiac arrest. The analyses include both in- and out-of-hospital cardiac arrests. The 6-month mortality rate for the entire group was 81%. Mortality rate was 94% for the oldest group (more than 80 yrs) compared with 68% for the youngest group (less than equals 45 yrs) (p less than .01). Other independent predictors of mortality were history of diabetes mellitus, inhospital arrests, arrest time of more than 5 mins, history of congestive heart failure, a noncardiac cause of arrest, and cardiopulmonary resuscitation time of more than 20 mins. Of the 774 patients, 27% recovered good neurologic function. There was no statistically significant difference in neurologic recovery rates by age. Multivariate analysis showed that independent predictors of good neurologic recovery were: no history of diabetes mellitus, a cardiac cause of arrest, short arrest time, and short cardiopulmonary resuscitation time. Increasing age was a factor in postresuscitation mortality, but was not an independent predictor of poor neurologic outcome.

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