Survival After Out-of-Hospital Cardiac Arrest in Relation to Age and Early Identification of Patients With Minimal Chance of Long-Term Survival.
BACKGROUND
Survival after out-of-hospital cardiac arrest has increased during the last decade in Denmark. We aimed to study the impact of age on changes in survival and whether it was possible to identify patients with minimal chance of 30-day survival.


RESULTS
Using data from the nationwide Danish Cardiac Arrest Registry (2001─2011), we identified 21 480 patients ≥18 years old with a presumed cardiac-caused out-of-hospital cardiac arrest for which resuscitation was attempted. Patients were divided into 3 preselected age-groups: working-age patients 18 to 65 years of age (33.7%), early senior patients 66 to 80 years of age (41.5%), and late senior patients >80 years of age (24.8%). Characteristics in working-age patients, early senior patients, and late senior patients were as follows: witnessed arrest in 53.8%, 51.1%, and 52.1%; bystander cardiopulmonary resuscitation in 44.7%, 30.3%, and 23.4%; and prehospital shock from a defibrillator in 54.7%, 45.0%, and 33.8% (all P<0.05). Between 2001 and 2011, return of spontaneous circulation on hospital arrival increased: working-age patients, from 12.1% to 34.6%; early senior patients, from 6.4% to 21.5%; and late senior patients, from 4.0% to 15.0% (all P<0.001). Furthermore, 30-day survival increased: working-age patients, 5.8% to 22.0% (P<0.001); and early senior patients, 2.7% to 8.4% (P<0.001), whereas late senior patients experienced only a minor increase (1.5% to 2.0%; P=0.01). Overall, 3 of 9499 patients achieved 30-day survival if they met 2 criteria: had not achieved return of spontaneous circulation on hospital arrival and had not received a prehospital shock from a defibrillator.


CONCLUSIONS
All age groups experienced a large temporal increase in survival on hospital arrival, but the increase in 30-day survival was most prominent in the young. With the use of only 2 criteria, it was possible to identify patients with a minimal chance of 30-day survival.
From Department of Cardiology, Copenhagen University Hospital Gentofte, Hellerup, Denmark (M.W., F.F., C.M.H., S.R., L.K., K.B.S., P.W., G.H.G.); Prehospital Emergency Medical Services: The Capital Region of Denmark, Copenhagen, Denmark (F.K.L., S.L.N.); Institute of Health, Science and Technology, Aalborg University, Denmark (K.K., S.M.H., R.N.M., C.T.P.); The Heart Centre, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark (B.R., L.K.); Prehospital Emergency Medical Services: The Central Denmark Region, Denmark (E.F.C.); Department of Anaesthesia, Centre of Head and Orthopaedics, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark (S.L.N.); and National Institute of Public Health, University of Southern Denmark, Copenhagen, Denmark (G.H.G.). Mads.Wissenberg.Joergensen@regionh.dk.
Mads
M
Wissenberg
From Department of Cardiology, Copenhagen University Hospital Gentofte, Hellerup, Denmark (M.W., F.F., C.M.H., S.R., L.K., K.B.S., P.W., G.H.G.); Prehospital Emergency Medical Services: The Capital Region of Denmark, Copenhagen, Denmark (F.K.L., S.L.N.); Institute of Health, Science and Technology, Aalborg University, Denmark (K.K., S.M.H., R.N.M., C.T.P.); The Heart Centre, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark (B.R., L.K.); Prehospital Emergency Medical Services: The Central Denmark Region, Denmark (E.F.C.); Department of Anaesthesia, Centre of Head and Orthopaedics, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark (S.L.N.); and National Institute of Public Health, University of Southern Denmark, Copenhagen, Denmark (G.H.G.).
Fredrik
F
Folke
From Department of Cardiology, Copenhagen University Hospital Gentofte, Hellerup, Denmark (M.W., F.F., C.M.H., S.R., L.K., K.B.S., P.W., G.H.G.); Prehospital Emergency Medical Services: The Capital Region of Denmark, Copenhagen, Denmark (F.K.L., S.L.N.); Institute of Health, Science and Technology, Aalborg University, Denmark (K.K., S.M.H., R.N.M., C.T.P.); The Heart Centre, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark (B.R., L.K.); Prehospital Emergency Medical Services: The Central Denmark Region, Denmark (E.F.C.); Department of Anaesthesia, Centre of Head and Orthopaedics, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark (S.L.N.); and National Institute of Public Health, University of Southern Denmark, Copenhagen, Denmark (G.H.G.).
Carolina Malta
CM
Hansen
From Department of Cardiology, Copenhagen University Hospital Gentofte, Hellerup, Denmark (M.W., F.F., C.M.H., S.R., L.K., K.B.S., P.W., G.H.G.); Prehospital Emergency Medical Services: The Capital Region of Denmark, Copenhagen, Denmark (F.K.L., S.L.N.); Institute of Health, Science and Technology, Aalborg University, Denmark (K.K., S.M.H., R.N.M., C.T.P.); The Heart Centre, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark (B.R., L.K.); Prehospital Emergency Medical Services: The Central Denmark Region, Denmark (E.F.C.); Department of Anaesthesia, Centre of Head and Orthopaedics, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark (S.L.N.); and National Institute of Public Health, University of Southern Denmark, Copenhagen, Denmark (G.H.G.).
Freddy K
FK
Lippert
From Department of Cardiology, Copenhagen University Hospital Gentofte, Hellerup, Denmark (M.W., F.F., C.M.H., S.R., L.K., K.B.S., P.W., G.H.G.); Prehospital Emergency Medical Services: The Capital Region of Denmark, Copenhagen, Denmark (F.K.L., S.L.N.); Institute of Health, Science and Technology, Aalborg University, Denmark (K.K., S.M.H., R.N.M., C.T.P.); The Heart Centre, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark (B.R., L.K.); Prehospital Emergency Medical Services: The Central Denmark Region, Denmark (E.F.C.); Department of Anaesthesia, Centre of Head and Orthopaedics, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark (S.L.N.); and National Institute of Public Health, University of Southern Denmark, Copenhagen, Denmark (G.H.G.).
Kristian
K
Kragholm
From Department of Cardiology, Copenhagen University Hospital Gentofte, Hellerup, Denmark (M.W., F.F., C.M.H., S.R., L.K., K.B.S., P.W., G.H.G.); Prehospital Emergency Medical Services: The Capital Region of Denmark, Copenhagen, Denmark (F.K.L., S.L.N.); Institute of Health, Science and Technology, Aalborg University, Denmark (K.K., S.M.H., R.N.M., C.T.P.); The Heart Centre, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark (B.R., L.K.); Prehospital Emergency Medical Services: The Central Denmark Region, Denmark (E.F.C.); Department of Anaesthesia, Centre of Head and Orthopaedics, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark (S.L.N.); and National Institute of Public Health, University of Southern Denmark, Copenhagen, Denmark (G.H.G.).
Bjarke
B
Risgaard
From Department of Cardiology, Copenhagen University Hospital Gentofte, Hellerup, Denmark (M.W., F.F., C.M.H., S.R., L.K., K.B.S., P.W., G.H.G.); Prehospital Emergency Medical Services: The Capital Region of Denmark, Copenhagen, Denmark (F.K.L., S.L.N.); Institute of Health, Science and Technology, Aalborg University, Denmark (K.K., S.M.H., R.N.M., C.T.P.); The Heart Centre, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark (B.R., L.K.); Prehospital Emergency Medical Services: The Central Denmark Region, Denmark (E.F.C.); Department of Anaesthesia, Centre of Head and Orthopaedics, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark (S.L.N.); and National Institute of Public Health, University of Southern Denmark, Copenhagen, Denmark (G.H.G.).
Shahzleen
S
Rajan
From Department of Cardiology, Copenhagen University Hospital Gentofte, Hellerup, Denmark (M.W., F.F., C.M.H., S.R., L.K., K.B.S., P.W., G.H.G.); Prehospital Emergency Medical Services: The Capital Region of Denmark, Copenhagen, Denmark (F.K.L., S.L.N.); Institute of Health, Science and Technology, Aalborg University, Denmark (K.K., S.M.H., R.N.M., C.T.P.); The Heart Centre, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark (B.R., L.K.); Prehospital Emergency Medical Services: The Central Denmark Region, Denmark (E.F.C.); Department of Anaesthesia, Centre of Head and Orthopaedics, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark (S.L.N.); and National Institute of Public Health, University of Southern Denmark, Copenhagen, Denmark (G.H.G.).
Lena
L
Karlsson
From Department of Cardiology, Copenhagen University Hospital Gentofte, Hellerup, Denmark (M.W., F.F., C.M.H., S.R., L.K., K.B.S., P.W., G.H.G.); Prehospital Emergency Medical Services: The Capital Region of Denmark, Copenhagen, Denmark (F.K.L., S.L.N.); Institute of Health, Science and Technology, Aalborg University, Denmark (K.K., S.M.H., R.N.M., C.T.P.); The Heart Centre, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark (B.R., L.K.); Prehospital Emergency Medical Services: The Central Denmark Region, Denmark (E.F.C.); Department of Anaesthesia, Centre of Head and Orthopaedics, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark (S.L.N.); and National Institute of Public Health, University of Southern Denmark, Copenhagen, Denmark (G.H.G.).
Kathrine Bach
KB
Søndergaard
From Department of Cardiology, Copenhagen University Hospital Gentofte, Hellerup, Denmark (M.W., F.F., C.M.H., S.R., L.K., K.B.S., P.W., G.H.G.); Prehospital Emergency Medical Services: The Capital Region of Denmark, Copenhagen, Denmark (F.K.L., S.L.N.); Institute of Health, Science and Technology, Aalborg University, Denmark (K.K., S.M.H., R.N.M., C.T.P.); The Heart Centre, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark (B.R., L.K.); Prehospital Emergency Medical Services: The Central Denmark Region, Denmark (E.F.C.); Department of Anaesthesia, Centre of Head and Orthopaedics, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark (S.L.N.); and National Institute of Public Health, University of Southern Denmark, Copenhagen, Denmark (G.H.G.).
Steen M
SM
Hansen
From Department of Cardiology, Copenhagen University Hospital Gentofte, Hellerup, Denmark (M.W., F.F., C.M.H., S.R., L.K., K.B.S., P.W., G.H.G.); Prehospital Emergency Medical Services: The Capital Region of Denmark, Copenhagen, Denmark (F.K.L., S.L.N.); Institute of Health, Science and Technology, Aalborg University, Denmark (K.K., S.M.H., R.N.M., C.T.P.); The Heart Centre, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark (B.R., L.K.); Prehospital Emergency Medical Services: The Central Denmark Region, Denmark (E.F.C.); Department of Anaesthesia, Centre of Head and Orthopaedics, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark (S.L.N.); and National Institute of Public Health, University of Southern Denmark, Copenhagen, Denmark (G.H.G.).
Rikke Normark
RN
Mortensen
From Department of Cardiology, Copenhagen University Hospital Gentofte, Hellerup, Denmark (M.W., F.F., C.M.H., S.R., L.K., K.B.S., P.W., G.H.G.); Prehospital Emergency Medical Services: The Capital Region of Denmark, Copenhagen, Denmark (F.K.L., S.L.N.); Institute of Health, Science and Technology, Aalborg University, Denmark (K.K., S.M.H., R.N.M., C.T.P.); The Heart Centre, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark (B.R., L.K.); Prehospital Emergency Medical Services: The Central Denmark Region, Denmark (E.F.C.); Department of Anaesthesia, Centre of Head and Orthopaedics, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark (S.L.N.); and National Institute of Public Health, University of Southern Denmark, Copenhagen, Denmark (G.H.G.).
Peter
P
Weeke
From Department of Cardiology, Copenhagen University Hospital Gentofte, Hellerup, Denmark (M.W., F.F., C.M.H., S.R., L.K., K.B.S., P.W., G.H.G.); Prehospital Emergency Medical Services: The Capital Region of Denmark, Copenhagen, Denmark (F.K.L., S.L.N.); Institute of Health, Science and Technology, Aalborg University, Denmark (K.K., S.M.H., R.N.M., C.T.P.); The Heart Centre, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark (B.R., L.K.); Prehospital Emergency Medical Services: The Central Denmark Region, Denmark (E.F.C.); Department of Anaesthesia, Centre of Head and Orthopaedics, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark (S.L.N.); and National Institute of Public Health, University of Southern Denmark, Copenhagen, Denmark (G.H.G.).
Erika Frischknecht
EF
Christensen
From Department of Cardiology, Copenhagen University Hospital Gentofte, Hellerup, Denmark (M.W., F.F., C.M.H., S.R., L.K., K.B.S., P.W., G.H.G.); Prehospital Emergency Medical Services: The Capital Region of Denmark, Copenhagen, Denmark (F.K.L., S.L.N.); Institute of Health, Science and Technology, Aalborg University, Denmark (K.K., S.M.H., R.N.M., C.T.P.); The Heart Centre, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark (B.R., L.K.); Prehospital Emergency Medical Services: The Central Denmark Region, Denmark (E.F.C.); Department of Anaesthesia, Centre of Head and Orthopaedics, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark (S.L.N.); and National Institute of Public Health, University of Southern Denmark, Copenhagen, Denmark (G.H.G.).
Søren L
SL
Nielsen
From Department of Cardiology, Copenhagen University Hospital Gentofte, Hellerup, Denmark (M.W., F.F., C.M.H., S.R., L.K., K.B.S., P.W., G.H.G.); Prehospital Emergency Medical Services: The Capital Region of Denmark, Copenhagen, Denmark (F.K.L., S.L.N.); Institute of Health, Science and Technology, Aalborg University, Denmark (K.K., S.M.H., R.N.M., C.T.P.); The Heart Centre, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark (B.R., L.K.); Prehospital Emergency Medical Services: The Central Denmark Region, Denmark (E.F.C.); Department of Anaesthesia, Centre of Head and Orthopaedics, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark (S.L.N.); and National Institute of Public Health, University of Southern Denmark, Copenhagen, Denmark (G.H.G.).
Gunnar H
GH
Gislason
From Department of Cardiology, Copenhagen University Hospital Gentofte, Hellerup, Denmark (M.W., F.F., C.M.H., S.R., L.K., K.B.S., P.W., G.H.G.); Prehospital Emergency Medical Services: The Capital Region of Denmark, Copenhagen, Denmark (F.K.L., S.L.N.); Institute of Health, Science and Technology, Aalborg University, Denmark (K.K., S.M.H., R.N.M., C.T.P.); The Heart Centre, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark (B.R., L.K.); Prehospital Emergency Medical Services: The Central Denmark Region, Denmark (E.F.C.); Department of Anaesthesia, Centre of Head and Orthopaedics, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark (S.L.N.); and National Institute of Public Health, University of Southern Denmark, Copenhagen, Denmark (G.H.G.).
Lars
L
Køber
From Department of Cardiology, Copenhagen University Hospital Gentofte, Hellerup, Denmark (M.W., F.F., C.M.H., S.R., L.K., K.B.S., P.W., G.H.G.); Prehospital Emergency Medical Services: The Capital Region of Denmark, Copenhagen, Denmark (F.K.L., S.L.N.); Institute of Health, Science and Technology, Aalborg University, Denmark (K.K., S.M.H., R.N.M., C.T.P.); The Heart Centre, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark (B.R., L.K.); Prehospital Emergency Medical Services: The Central Denmark Region, Denmark (E.F.C.); Department of Anaesthesia, Centre of Head and Orthopaedics, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark (S.L.N.); and National Institute of Public Health, University of Southern Denmark, Copenhagen, Denmark (G.H.G.).
Christian
C
Torp-Pedersen
D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D001775:Blood Circulation; D016887:Cardiopulmonary Resuscitation / Q000706:statistics & numerical data; D003718:Denmark; D004554:Electric Countershock / Q000706:statistics & numerical data; D004632:Emergency Medical Services; D005260:Female; D005392:First Aid; D006801:Humans; D008297:Male; D008875:Middle Aged; D009026:Mortality / Q000639:trends; D058687:Out-of-Hospital Cardiac Arrest / Q000401:mortality*; D011379:Prognosis; D012042:Registries / Q000706:statistics & numerical data; D055815:Young Adult
age; heart arrest; resuscitation; survival