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Author Notes:

Correspondence to: Paul S. Chan, MD, MSc, Mid America Heart Institute, 5th Floor, 4401 Wornall Rd, Kansas City, MO 64111. E‐mail: pchan@saint-lukes.org

Disclosures: None

Subjects:

Research Funding:

Dr Chan is supported by funding (K23HL102224 and R01HL123980) from the National Heart, Lung, and Blood Institute.

CARES was funded by the Centers for Disease Control and Prevention from 2004 to 2012.

The program is now supported through private funding from the American Red Cross, the Medtronic Foundation Heart Rescue Program, the American Heart Association, Zoll Corporation, and in‐kind support from Emory University.

Keywords:

  • Science & Technology
  • Life Sciences & Biomedicine
  • Cardiac & Cardiovascular Systems
  • Cardiovascular System & Cardiology
  • cardiac arrest
  • cost
  • outcomes research
  • survival
  • AMERICAN-HEART-ASSOCIATION
  • CARDIOPULMONARY-RESUSCITATION
  • REGISTRY
  • UPDATE

Long-Term Outcomes Among Elderly Survivors of Out-of-Hospital Cardiac Arrest

Tools:

Journal Title:

Journal of the American Heart Association

Volume:

Volume 5, Number 3

Publisher:

, Pages e002924-e002924

Type of Work:

Article | Final Publisher PDF

Abstract:

Background-Most studies on out-of-hospital cardiac arrest have focused on immediate survival. However, little is known about long-term outcomes and resource use among survivors. Methods and Results-Within the national CARES registry, we identified 16 206 adults 65 years or older with an out-of-hospital cardiac arrest between 2005 and 2010. Among 1127 patients who were discharged alive, we evaluated whether 1-year mortality, cumulative readmission incidence, and follow-up inpatient costs differed according to patients' race, sex, initial cardiac arrest rhythm, bystander delivery of cardiopulmonary resuscitation, discharge neurological status, and functional status (hospital discharge disposition). Overall 1-year mortality after hospital discharge was 31.8%. Among survivors, there were no long-term mortality differences by sex, race, or initial cardiac arrest rhythm, but worse functional status and severe neurological disability at discharge were associated with higher mortality. Moreover, compared with first responders, cardiopulmonary resuscitation delivered by bystanders was associated with 23% lower mortality (hazard ratio 0.77 [confidence interval 0.58-1.02]). Besides mortality, 638 (56.6%) patients were readmitted within the first year, and the cumulative readmission incidence was 197 per 100 patient-years. Mean 1-year inpatient costs were $23 765±41 002. Younger age, black race, severe neurological disability at discharge, and hospital disposition to a skilled nursing or rehabilitation facility were each associated with higher 1-year inpatient costs (P for all <0.05). Conclusion-Among elderly survivors of out-of-hospital cardiac arrest, nearly 1 in 3 patients die within the first year. Long-term mortality and inpatient costs differed substantially by certain demographic factors, whether cardiopulmonary resuscitation was initiated by a bystander, discharge neurological status, and hospital disposition.

Copyright information:

© 2016 The Authors.

This is an Open Access work distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 International License (http://creativecommons.org/licenses/by-nc/4.0/).

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