title: Improved Survival With Favorable Neurological Outcome in Elderly Individuals With Out-of-Hospital Cardiac Arrest in Japan　- A Nationwide Observational Cohort Study.
abstract: BACKGROUND
  There is sparse data regarding the survival and neurological outcome of elderly patients with out-of-hospital cardiac arrest (OHCA).
  
  
  RESULTS
  OHCA patients (334,730) aged ≥75 years were analyzed using a nationwide, prospective, population-based Japanese OHCA database from 2008 to 2012. The overall 1-month survival with favorable neurological outcome (Cerebral Performance Category Scale, category 1 or 2; CPC 1-2) rate was 0.88%. During the study period, the annual 1-month CPC 1-2 rate in whole OHCA significantly improved (0.73% to 0.96%, P for trend <0.001). In particular, outcomes of OHCA patients aged 75 to 84 years and those aged 85 to 94 years significantly improved (0.98% to 1.28%, P for trend=0.01; 0.46% to 0.70%, P for trend <0.001, respectively). However, in OHCA patients aged ≥95 years, the outcomes did not improve. Multivariate logistic regression analysis indicated that younger age, shockable first documented rhythm, witnessed arrest, earlier emergency medical service (EMS) response time, and cardiac etiology were significantly associated with the 1-month CPC 1-2. Under these conditions, elderly OHCA patients who had cardiac etiology, shockable rhythm and had a witnessed arrest had acceptable 1-month CPC1-2 rate; 7.98% in cases where OHCA was witnessed by family, 15.2% by non-family, and 25.6% by EMS.
  
  
  CONCLUSIONS
  The annual 1-month CPC 1-2 rate after OHCA among elderly patients significantly improved, and the resuscitation of elderly patients in a selected population is not futile. (Circ J 2016; 80: 1153-1162).
authors.affiliation: Department of Emergency and Critical Care Medicine, Kanazawa University Hospital.
authors.forename: Akira
authors.initials: A
authors.lastname: Funada
authors.forename: Yoshikazu
authors.initials: Y
authors.lastname: Goto
authors.forename: Tetsuo
authors.initials: T
authors.lastname: Maeda
authors.forename: Ryota
authors.initials: R
authors.lastname: Teramoto
authors.forename: Kenshi
authors.initials: K
authors.lastname: Hayashi
authors.forename: Masakazu
authors.initials: M
authors.lastname: Yamagishi
mesh_terms: D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D016887:Cardiopulmonary Resuscitation; D015331:Cohort Studies; D016208:Databases, Factual; D006801:Humans; D007564:Japan; D009422:Nervous System Diseases / Q000209:etiology; D058687:Out-of-Hospital Cardiac Arrest / Q000150:complications / Q000401:mortality*; D011446:Prospective Studies; D015996:Survival Rate; D016896:Treatment Outcome