@article{0541defd4abd4078bd5b9ba2921b51a4,
title = "Impact of age on survival of patients with out-of-hospital cardiac arrest transported to tertiary emergency medical institutions in Osaka, Japan",
abstract = "Aim: The purpose of this study was to evaluate the out-of-hospital cardiac arrest (OHCA) characteristics of patients stratified by age who had resuscitation attempted and were transported to tertiary emergency medical institutions in Osaka Prefecture, Japan; especially those of advanced age. Methods: A prospective, population-based, observational review was carried out of consecutive OHCA patients with emergency responder resuscitation attempts from July 2012 to December 2016 in Osaka, Japan. Patients were classified into four groups: (i) 18–64 years; (ii) 65–74 years; (iii) 75–84 years; and (iv) ≥85 years. Patient, event and treatment characteristics were examined for patients with presumed cardiac etiology of OHCA. The primary outcome was the 1-month survival with a neurologically favorable outcome. Results: A total of 4636 patients with OHCA of presumed cardiac origin were transported to tertiary emergency medical institutions. The number of patients in the four groups was as follows: (i) 1290 (27.8%); (ii) 1102 (23.8%); (iii) 1420 (30.6%); and (iv) 824 (17.8%). The 1-month survival with a neurologically favorable outcome was: (i) 207 (16.0%); (ii) 96 (8.7%); (iii) 60 (4.2%); and (iv) seven (0.85%). In a multivariate analysis for 1-month survival with a neurologically favorable outcome, increased age was a significant prognostic factor (≥85 years; adjusted odds ratio 0.08, 95% confidence interval 0.03–0.23) for poor outcomes. Conclusions: In this population, advanced age (≥85 years) was strongly associated with poor outcomes. Further discussion of policies directed at resuscitation of very elderly OHCA patients is required, considering limited medical resources and the rapidly aging population in Japan. Geriatr Gerontol Int 2019; 19: 1088–1095.",
keywords = "Comprehensive Registry of In-hospital Intensive Care for OHCA Survival, age, cerebral performance category, out-of-hospital cardiac arrest, outcome",
author = "{for the CRITICAL Study investigators} and Fumiko Nakamura and Kentaro Kajino and Tetsuhisa Kitamura and Daya, {Mohamud R.} and Ong, {Marcus E.H.} and Tasuku Matsuyama and Tomoki Yamada and Koichi Hayakawa and Taro Irisawa and Kazuhisa Yoshiya and Kazuo Noguchi and Tetsuro Nishimura and Toshifumi Uejima and Yoshiki Yagi and Takeyuki Kiguchi and Masafumi Kishimoto and Makoto Matsuura and Yasuyuki Hayashi and Taku Sogabe and Takaya Morooka and Taku Iwami and Takeshi Shimazu and Yasuyuki Kuwagata",
note = "Funding Information: We are deeply indebted to all members of the CRITICAL study group for their contribution. The CRITICAL study group consist of the following institutions: Osaka University Hospital Trauma and Acute Critical Care Center; Osaka Mishima Emergency Critical Care Center; Senri Critical Care Medical Center, Osaka Saiseikai Senri Hospital; Emergency and Critical Care Medical Center, Osaka City General Hospital; Osaka Prefectural Nakakawachi Medical Center of Acute Medicine; Traumatology and Critical Care Medical Center, National Hospital Organization Osaka National Hospital; Emergency and Critical Care Medical Center, Osaka Police Hospital; Critical Care and Trauma Center, Osaka General Medical Center; Department of Emergency and Critical Care Medicine, Kinki University School of Medicine; Osaka Prefectural Senshu Critical Care Medical Center; Department of Critical Care Medicine, Osaka City University; Department of Emergency Medicine, Tane General Hospital; Department of Emergency and Critical Care Medicine, Kansai Medical University Medical Center; and Department of Emergency and Critical Care Medicine, Kansai Medical Univercity. We are also deeply grateful to all EMS personnel in Osaka Prefecture for collecting Utstein data. This registry was supported by a scientific research grant from the Ministry of Education, Culture, Sports, Science and Technology of Japan (grant numbers: 15H05006, 16K09034, 19K09393). Funding Information: This registry was supported by a scientific research grant from the Ministry of Education, Culture, Sports, Science and Technology of Japan (grant numbers: 15H05006, 16K09034, 19K09393). Publisher Copyright: {\textcopyright} 2019 Japan Geriatrics Society",
year = "2019",
month = nov,
day = "1",
doi = "10.1111/ggi.13779",
language = "English (US)",
volume = "19",
pages = "1088--1095",
journal = "Geriatrics and Gerontology International",
issn = "1447-0594",
publisher = "Japan Geriatrics Society",
number = "11",
}