Factors Associated with the Short-Term Survival from Cardiopulmonary Resuscitation (CPR) among Older Patients in a Middle-Income Country
Rujikunanant W, MD1, Kamsom A, MSc2, Sri-on J, MD1
Affiliation : 1 Department of Emergency Medicine, Vajira Hospital, Navamindradhiraj University, Bangkok, Thailand 2 Department of Biostatistic, Vajira Hospital, Navamindradhiraj University, Bangkok, Thailand
Objective : The present study was aimed to explore factors associated with short-term survival from CPR among older patients in
a middle-income country.
Materials and Methods : The author retrospectively reviewed data of all patients aged 60 years and older who presented to our
emergency department (ED) after out-of-hospital cardiac arrest (OHCA) during 2010 to 2017. Data collection was done using
Utstein-Style Guidelines for uniform reporting of data by trained research assistants.
The primary outcome was to determine the success rate of CPR and factors associated with 7-days survival in OHCA
among older patients. Data was calculated using appropriate statistical analysis. Overall survival from each factor were presented
by median survival time, which analyzed in to hazard ratio.
Results : We had 308 patients in the present study. One hundred and sixty-five patients (53.6%) were female, with a mean age of
74.78+9.50 years. An average CPR time was 26.75+16.64 minutes and average time to return of spontaneous circulation (ROSC)
was 17.56+12.95 minutes. A total of 163 (52.9%) achieved ROSC and 88 (28.6%) patients survived to hospital admission. Overall
median survival time was 7 days.
In multivariable analysis model, patients with first recorded ECG as asystole (HRadj 1.53 95% CI 1.18 to 1.98) and those
required time to ROSC more than 12 minutes (HRadj 3.21 95% CI 2.98 to 4.74) decreased a chance of survival.
Conclusion : Half of the older patients had ROSC and almost one-third survived to hospital admission. Asystole and time to ROSC >12
minutes decreased a chance of 7 days survival among older adults. The present study may give some idea in crucial decision-making
for out of hospital cardiac arrest among older adults.
Keywords : Short-term survival, Cardiopulmonary resuscitation, Elderly patients
