title: Cardiocerebral resuscitation improves out-of-hospital survival in older adults.
abstract: OBJECTIVE
  To compare the survival and neurological status of people aged 65 and older receiving cardiocerebral resuscitation (CCR) with that of those receiving standard advanced life support (Std-ALS), as well as predictors of survival.
  
  
  METHODS
  Historical prospective cohort study.
  
  
  METHODS
  The Save Hearts in Arizona Registry (SHARE).
  
  
  METHODS
  Persons who had experienced cardiac arrest receiving CCR or Std-ALS.
  
  
  METHODS
  Patient demographics, emergency medical service events, survival to hospital discharge, and out-of-hospital cardiac arrest (OHCA) outcomes were obtained from Arizona hospital records and Bureau of Public Health Statistics from 2005 to 2008.
  
  
  RESULTS
  People receiving CCR were twice as likely to survive as those receiving Std-ALS (adjusted odds ratio=2.0, P=.005). An additional 20 per 1,000 older adults would survive, above the background survival rate of Std-ALS, if given CCR. More than 96% of those receiving CCR had good or moderate neurological outcomes, compared with 89% of those receiving Std.-ALS (P=.41).
  
  
  CONCLUSIONS
  CCR is associated with superior survival outcomes than Std-ALS for OHCAs in people aged 65 and older. Use of CCR in older adults without known do-not-resuscitate status is warranted. These findings should be understood within the broader context of the essential role of comprehensive advance care planning in providing care consistent with patient goals and values.
authors.affiliation: Arizona Center on Aging, University of Arizona, Tucson, Arizona, USA. jmohler@aging.arizona.edu
authors.forename: M Jane
authors.initials: MJ
authors.lastname: Mohler
authors.forename: Christopher S
authors.initials: CS
authors.lastname: Wendel
authors.forename: Jarrod
authors.initials: J
authors.lastname: Mosier
authors.forename: Ajit
authors.initials: A
authors.lastname: Itty
authors.forename: Mindy
authors.initials: M
authors.lastname: Fain
authors.forename: Lani
authors.initials: L
authors.lastname: Clark
authors.forename: Bentley
authors.initials: B
authors.lastname: Bobrow
authors.forename: Arthur B
authors.initials: AB
authors.lastname: Sanders
mesh_terms: D000203:Activities of Daily Living; D022561:Advanced Cardiac Life Support / Q000379:methods; D000368:Aged; D000369:Aged, 80 and over; D001130:Arizona / Q000453:epidemiology; D016887:Cardiopulmonary Resuscitation / Q000379:methods*; D004638:Emergency Treatment / Q000379:methods; D005260:Female; D006323:Heart Arrest / Q000401:mortality / Q000628:therapy*; D006801:Humans; D008297:Male; D011446:Prospective Studies; D015996:Survival Rate; D016896:Treatment Outcome