Abstract 19974: Medicalized Prehospital Care in the Elderly: Facing Age Discrimination
Introduction: Few studies report results on cardiac arrests (CA) care in the elderly. Even if age is not considered as an essential prognostic factor some studies questioned if cardiopulmonary resuscitation (CPR) in the elderly could be futile. Nevertheless in daily clinical practice, age seems to be an important factor conditioning CA care.
Hypothesis: The aim of this case-control study was to compare out of hospital cardiac arrest care and outcome between young (<65 years old) and elderly patients.
Methods: We performed a prospective case-control study based on data extracted from the French National CA registry. All adult patients (>18 years old) with CA recorded between July 2011 and May 2014 were included. Each elderly (>=65 years old) patient (case) was matched on 3 criteria: sex, initial cardiac rhythm, and the no-flow duration.
Results: We studied 4,347 pairs. We significantly found less BLS starting, ACLS duration, mobile medical team (MMT) automated chest compression, MMT ventilation and MMT epinephrine injection in the elderly. Statistical differences were also observed for return of spontaneous circulation (ROSC) (OR=0.84[0.77-0.92]), transport to hospital (OR=0.58[0.51-0.61]), vital status at hospital admission (OR=0.55[0.50-0.60]), vital status at Day 30 (OR=0.42[0.35-0.50]), and Cerebral Performance Category (CPC) at Day 30 (OR=0.44[0.37-0.53]).
Conclusions: All CA guidelines, ethical statement, clinical procedures do not propose age as a discrimination criterion in OHCA care. However, our study shows that with similar CA conditions, elderly patients are victims of medical discrimination by a shorter duration and less intensive care leading to a lower survival rate compared to young people.
Author Disclosures: E. Wiel: None. N. Segal: None. C. Di Pompéo: None. J. Marc: None. C. Vanderstraeten: None. M. Doukhan: None. J. Escutnaire: None. P. Gueugniaud: None. H. Hubert: None.
- © 2015 by American Heart Association, Inc.