title: Out-of-hospital cardiac arrest in the elderly: A large-scale population-based study.
abstract: BACKGROUND
  There is little information on elderly people who suffer from out-of-hospital cardiac arrest (OHCA).
  
  
  OBJECTIVE
  To determine 30-day mortality and neurological outcome in elderly patients with OHCA.
  
  
  METHODS
  OHCA patients ≥ 70 years of age who were registered in the Swedish Cardiopulmonary Resuscitation Register between 1990 and 2013 were included and divided into three age categories (70-79, 80-89, and ≥ 90 years). Multiple logistic regression analyses were performed to identify independent predictors of 30-day survival.
  
  
  RESULTS
  Altogether, 36,605 cases were included in the study. Thirty-day survival was 6.7% in patients aged 70-79 years, 4.4% in patients aged 80-89 years, and 2.4% in those over 90 years. For patients with witnessed OHCA of cardiac aetiology found in a shockable rhythm, survival was higher: 20%, 15%, and 11%, respectively. In 30-day survivors, the distribution according to the cerebral performance categories (CPC) score at discharge from hospital was similar in the three age groups. In multivariate analysis, in patients over 70 years of age, the following factors were associated with increased chance of 30-day survival: younger age, OHCA outside the home, witnessed OHCA, CPR before arrival of EMS, shockable first-recorded rhythm, and short emergency response time.
  
  
  CONCLUSIONS
  Advanced age is an independent predictor of mortality in OHCA patients over 70 years of age. However, even in patients above 90 years of age, defined subsets with a survival rate of more than 10% exist. In survivors, the neurological outcome remains similar regardless of age.
authors.affiliation: Department of Cardiology, Sahlgrenska University Hospital, Gothenburg, Sweden. Electronic address: berglind.libungan@vgregion.se.
authors.forename: Berglind
authors.initials: B
authors.lastname: Libungan
authors.affiliation: Department of Molecular and Clinical Medicine, Institute of Medicine, Sahlgrenska University Hospital, Gothenburg, Sweden.
authors.forename: Jonny
authors.initials: J
authors.lastname: Lindqvist
authors.affiliation: School of Health and Social Sciences, University of Dalarna, Falun, Sweden.
authors.forename: Anneli
authors.initials: A
authors.lastname: Strömsöe
authors.affiliation: Center for Resuscitation Science, Karolinska Institutet, Department of Medicine, Solna, Stockholm, Sweden.
authors.forename: Per
authors.initials: P
authors.lastname: Nordberg
authors.affiliation: Center for Resuscitation Science, Karolinska Institutet, Department of Medicine, Solna, Stockholm, Sweden.
authors.forename: Jacob
authors.initials: J
authors.lastname: Hollenberg
authors.affiliation: Department of Cardiology, Sahlgrenska University Hospital, Gothenburg, Sweden.
authors.forename: Per
authors.initials: P
authors.lastname: Albertsson
authors.affiliation: Center for Applied Biostatistics, Occupational and Environmental Medicine, Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden.
authors.forename: Thomas
authors.initials: T
authors.lastname: Karlsson
authors.affiliation: Sahlgrenska University Hospital and Center for Pre-hospital Research, Western Sweden University of Borås, Borås, Sweden.
authors.forename: Johan
authors.initials: J
authors.lastname: Herlitz
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D016887:Cardiopulmonary Resuscitation / Q000379:methods*; D004632:Emergency Medical Services / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D058687:Out-of-Hospital Cardiac Arrest / Q000401:mortality / Q000628:therapy*; D011159:Population Surveillance; D012042:Registries; D012189:Retrospective Studies; D015996:Survival Rate / Q000639:trends; D013548:Sweden / Q000453:epidemiology; D013997:Time Factors; D016896:Treatment Outcome
keywords: Elderly; Out-of-hospital cardiac arrest; Survival