Abstract 168: Age Alone Is Not a Predictor of Outcome in Post Cardiac Arrest
Introduction: Age is an independent predictor of morbidity and mortality in most forms of acute illness, including in cardiac arrest. However, the independent effect of age on outcome for a cardiac arrest patient who regains return of spontaneous circulation has not been well examined. We hypothesize that age is not a determining factor in post-cardiac arrest mortality or neurological outcome.
Methods: We performed an observational cohort study of survivors of cardiac arrest. Data was collected prospectively between 12/2007 and 2/2011. Inclusion criteria: age > 18 years; out-of-hospital or in-hospital cardiac arrest; successful return of spontaneous circulation (ROSC). Traumatic arrests were excluded. Data collected included baseline demographics including age. Outcomes data included neurologic outcome (Cerebral Performance Category) and mortality. We describe the population with simple descriptive statistics including means or medians with standard deviations or interquartile ranges or frequencies with percentages, as appropriate. We performed a univariate logistic regression with age as the independent variable to predict primary (death) and secondary outcome (poor neurologic outcome) and report Odds Ratios with 95% Confidence Intervals.
Results: A total of 229 patients were analyzed. The median age of the cohort was 70 (IQR: 56 - 79) and 72/229 (31.6%) were female. As a continuous predictor age was neither a predictor of in-hospital mortality (OR: 1.01, 95% CI: 0.99 - 1.03) nor of poor neurologic outcome (OR: 1.01 95% CI: 0.99 - 1.03). When categorized by 5- and 10-year intervals age remained unassociated with mortality (5-year OR: 1.07, 95% CI: 0.99 - 1.16; 10-year OR: 1.14, 95% CI 0.97 - 1.34) or neurological outcome (5-year OR: 1.07, 95% CI: 0.98 - 1.16; 10-year OR: 1.14, 95% CI 0.97 - 1.34).
Conclusion: As an independent variable, age is a poor predictor of morbidity and mortality in cardiac arrest patients who achieve return of spontaneous circulation. These data suggest that treatment strategies in post-cardiac arrest patients should be executed without regard to age and that age-adjusted analysis in post-cardiac arrest may not be necessary. Validation of this finding in a large cohort of post-cardiac arrest patients is necessary.
- © 2011 by American Heart Association, Inc.