Out-of-hospital cardiac arrests in the older population in Ireland

Richard Tanner, Siobhan Masterson, Mette Jensen, Peter Wright, David Hennelly, Martin O'Reilly, Andrew W. Murphy, Gerard Bury, Cathal O'Donnell, Conor Deasy

Research output: Contribution to journalArticleResearchpeer-review

Abstract

Introduction: Age influences survival from an out-of-hospital cardiac arrest (OHCA) but it is unclear to what extent. Improved understanding of the impact of increasing age may be helpful in improving decision making on who should receive attempted resuscitation to optimise outcomes and minimise inappropriate end-of-life management. Our aim is to describe the demographics, characteristics and outcomes following resuscitation attempts in OHCA patients aged 70 years and older in Ireland.Methods: Data were extracted from the national OHCA Register. Patient and event characteristics were compared across three age categories (70-79; 80-89; ≥90 years). Multivariable logistic regression was used to determine the predictors of the primary outcome (survival to hospital discharge).Results: A total of 2281 patients aged 70 years and older were attended by emergency medical services and had resuscitation attempted between 2012 and 2014. Overall survival to hospital discharge was 2.9%. For those aged 70-79 years, 80-89 years, 90 years and older survival to hospital discharge in each age group was 4.0%, 1.8% and 1.4%, respectively. Older age (adjusted OR (AOR) 0.95 95% CI 0.90 to 0.99) and having an arrest in the subjects own home (AOR 0.14 95% CI 0.07 to 0.28) were independent predictor associated with reduced odds of survival to hospital discharge. An initial shockable rhythm (AOR 17.9. 95% CI 8.19 to 39.2) and having a bystander witnessed OHCA (AOR 3.98. 95% CI 1.38 to 11.50) were independent predictors associated with increased odds of survival to hospital discharge.Conclusion: In those aged 70 years and older, the rate of survival to hospital discharge declined with increasing age group. Younger age, an initial shockable rhythm and witnessed arrest were independent predictors of survival to hospital discharge.

Original languageEnglish
Pages (from-to)659-664
Number of pages6
JournalEmergency Medicine Journal
Volume34
Issue number10
DOIs
Publication statusPublished - 27 Jun 2017
Externally publishedYes

Keywords

  • Older population

Cite this

Tanner, R., Masterson, S., Jensen, M., Wright, P., Hennelly, D., O'Reilly, M., ... Deasy, C. (2017). Out-of-hospital cardiac arrests in the older population in Ireland. Emergency Medicine Journal, 34(10), 659-664. https://doi.org/10.1136/emermed-2016-206041
Tanner, Richard ; Masterson, Siobhan ; Jensen, Mette ; Wright, Peter ; Hennelly, David ; O'Reilly, Martin ; Murphy, Andrew W. ; Bury, Gerard ; O'Donnell, Cathal ; Deasy, Conor. / Out-of-hospital cardiac arrests in the older population in Ireland. In: Emergency Medicine Journal. 2017 ; Vol. 34, No. 10. pp. 659-664.
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abstract = "Introduction: Age influences survival from an out-of-hospital cardiac arrest (OHCA) but it is unclear to what extent. Improved understanding of the impact of increasing age may be helpful in improving decision making on who should receive attempted resuscitation to optimise outcomes and minimise inappropriate end-of-life management. Our aim is to describe the demographics, characteristics and outcomes following resuscitation attempts in OHCA patients aged 70 years and older in Ireland.Methods: Data were extracted from the national OHCA Register. Patient and event characteristics were compared across three age categories (70-79; 80-89; ≥90 years). Multivariable logistic regression was used to determine the predictors of the primary outcome (survival to hospital discharge).Results: A total of 2281 patients aged 70 years and older were attended by emergency medical services and had resuscitation attempted between 2012 and 2014. Overall survival to hospital discharge was 2.9{\%}. For those aged 70-79 years, 80-89 years, 90 years and older survival to hospital discharge in each age group was 4.0{\%}, 1.8{\%} and 1.4{\%}, respectively. Older age (adjusted OR (AOR) 0.95 95{\%} CI 0.90 to 0.99) and having an arrest in the subjects own home (AOR 0.14 95{\%} CI 0.07 to 0.28) were independent predictor associated with reduced odds of survival to hospital discharge. An initial shockable rhythm (AOR 17.9. 95{\%} CI 8.19 to 39.2) and having a bystander witnessed OHCA (AOR 3.98. 95{\%} CI 1.38 to 11.50) were independent predictors associated with increased odds of survival to hospital discharge.Conclusion: In those aged 70 years and older, the rate of survival to hospital discharge declined with increasing age group. Younger age, an initial shockable rhythm and witnessed arrest were independent predictors of survival to hospital discharge.",
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Tanner, R, Masterson, S, Jensen, M, Wright, P, Hennelly, D, O'Reilly, M, Murphy, AW, Bury, G, O'Donnell, C & Deasy, C 2017, 'Out-of-hospital cardiac arrests in the older population in Ireland', Emergency Medicine Journal, vol. 34, no. 10, pp. 659-664. https://doi.org/10.1136/emermed-2016-206041

Out-of-hospital cardiac arrests in the older population in Ireland. / Tanner, Richard; Masterson, Siobhan; Jensen, Mette; Wright, Peter; Hennelly, David; O'Reilly, Martin; Murphy, Andrew W.; Bury, Gerard; O'Donnell, Cathal; Deasy, Conor.

In: Emergency Medicine Journal, Vol. 34, No. 10, 27.06.2017, p. 659-664.

Research output: Contribution to journalArticleResearchpeer-review

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T1 - Out-of-hospital cardiac arrests in the older population in Ireland

AU - Tanner, Richard

AU - Masterson, Siobhan

AU - Jensen, Mette

AU - Wright, Peter

AU - Hennelly, David

AU - O'Reilly, Martin

AU - Murphy, Andrew W.

AU - Bury, Gerard

AU - O'Donnell, Cathal

AU - Deasy, Conor

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N2 - Introduction: Age influences survival from an out-of-hospital cardiac arrest (OHCA) but it is unclear to what extent. Improved understanding of the impact of increasing age may be helpful in improving decision making on who should receive attempted resuscitation to optimise outcomes and minimise inappropriate end-of-life management. Our aim is to describe the demographics, characteristics and outcomes following resuscitation attempts in OHCA patients aged 70 years and older in Ireland.Methods: Data were extracted from the national OHCA Register. Patient and event characteristics were compared across three age categories (70-79; 80-89; ≥90 years). Multivariable logistic regression was used to determine the predictors of the primary outcome (survival to hospital discharge).Results: A total of 2281 patients aged 70 years and older were attended by emergency medical services and had resuscitation attempted between 2012 and 2014. Overall survival to hospital discharge was 2.9%. For those aged 70-79 years, 80-89 years, 90 years and older survival to hospital discharge in each age group was 4.0%, 1.8% and 1.4%, respectively. Older age (adjusted OR (AOR) 0.95 95% CI 0.90 to 0.99) and having an arrest in the subjects own home (AOR 0.14 95% CI 0.07 to 0.28) were independent predictor associated with reduced odds of survival to hospital discharge. An initial shockable rhythm (AOR 17.9. 95% CI 8.19 to 39.2) and having a bystander witnessed OHCA (AOR 3.98. 95% CI 1.38 to 11.50) were independent predictors associated with increased odds of survival to hospital discharge.Conclusion: In those aged 70 years and older, the rate of survival to hospital discharge declined with increasing age group. Younger age, an initial shockable rhythm and witnessed arrest were independent predictors of survival to hospital discharge.

AB - Introduction: Age influences survival from an out-of-hospital cardiac arrest (OHCA) but it is unclear to what extent. Improved understanding of the impact of increasing age may be helpful in improving decision making on who should receive attempted resuscitation to optimise outcomes and minimise inappropriate end-of-life management. Our aim is to describe the demographics, characteristics and outcomes following resuscitation attempts in OHCA patients aged 70 years and older in Ireland.Methods: Data were extracted from the national OHCA Register. Patient and event characteristics were compared across three age categories (70-79; 80-89; ≥90 years). Multivariable logistic regression was used to determine the predictors of the primary outcome (survival to hospital discharge).Results: A total of 2281 patients aged 70 years and older were attended by emergency medical services and had resuscitation attempted between 2012 and 2014. Overall survival to hospital discharge was 2.9%. For those aged 70-79 years, 80-89 years, 90 years and older survival to hospital discharge in each age group was 4.0%, 1.8% and 1.4%, respectively. Older age (adjusted OR (AOR) 0.95 95% CI 0.90 to 0.99) and having an arrest in the subjects own home (AOR 0.14 95% CI 0.07 to 0.28) were independent predictor associated with reduced odds of survival to hospital discharge. An initial shockable rhythm (AOR 17.9. 95% CI 8.19 to 39.2) and having a bystander witnessed OHCA (AOR 3.98. 95% CI 1.38 to 11.50) were independent predictors associated with increased odds of survival to hospital discharge.Conclusion: In those aged 70 years and older, the rate of survival to hospital discharge declined with increasing age group. Younger age, an initial shockable rhythm and witnessed arrest were independent predictors of survival to hospital discharge.

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Tanner R, Masterson S, Jensen M, Wright P, Hennelly D, O'Reilly M et al. Out-of-hospital cardiac arrests in the older population in Ireland. Emergency Medicine Journal. 2017 Jun 27;34(10):659-664. https://doi.org/10.1136/emermed-2016-206041