Increasing neurologically intact survival after out-of-hospital cardiac arrest among elderly: Singapore Experience
Objectives: With more elderly presenting with Out-of-Hospital Cardiac Arrests (OHCAs) globally, neurologically intact survival (NIS) should be the aim of resuscitation. We aimed to study the trend of OHCA amongst elderly in a large Asian registry to identify if age is independently associated with N...
| Main Authors: | , , , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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Elsevier
2024-03-01
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| Series: | Resuscitation Plus |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S2666520424000249 |
| _version_ | 1797242945910341632 |
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| author | Chloe Alexis Ong Gayathri Devi Nadarajan Stephanie Fook-Chong Nur Shahidah Shalini Arulanandam Yih Yng Ng Michael YC Chia Ling Tiah Desmond R Mao Wei Ming Ng Benjamin SH Leong Nausheen Doctor Marcus EH Ong Fahad J Siddiqui |
| author_facet | Chloe Alexis Ong Gayathri Devi Nadarajan Stephanie Fook-Chong Nur Shahidah Shalini Arulanandam Yih Yng Ng Michael YC Chia Ling Tiah Desmond R Mao Wei Ming Ng Benjamin SH Leong Nausheen Doctor Marcus EH Ong Fahad J Siddiqui |
| author_sort | Chloe Alexis Ong |
| collection | DOAJ |
| description | Objectives: With more elderly presenting with Out-of-Hospital Cardiac Arrests (OHCAs) globally, neurologically intact survival (NIS) should be the aim of resuscitation. We aimed to study the trend of OHCA amongst elderly in a large Asian registry to identify if age is independently associated with NIS and factors associated with NIS. Methods: All adult OHCAs aged ≥18 years attended by emergency medical services (EMS) from April 2010 to December 2019 in Singapore was extracted from the Pan-Asian Resuscitation Outcomes Study (PAROS) registry. Cases pronounced dead at scene, non-EMS transported, traumatic OHCAs and OHCAs in ambulances were excluded. Patient characteristics and outcomes were compared across four age categories (18–64, 65–79, 80–89, ≥90). Multivariable logistic regression analysis determined the factors associated with NIS. Results: 19,519 eligible cases were analyzed. OHCA incidence increased with age almost doubling in octogenarians (from 312/100,000 in 2011 to 652/100,000 in 2019) and tripling in those ≥90 years (from 458/100,000 in 2011 to 1271/100,000 in 2019). The proportion of patients with NIS improved over time for the 18–64, 65–79- and 80–89-years age groups, with the greatest improvement in the youngest group. NIS decreased with each increasing year of age and minute of response time. NIS increased in the arrests of presumed cardiac etiology, witnessed and bystander CPR. Conclusions: Survival with good outcomes has increased even amongst the elderly. Regardless of age, NIS is possible with good-quality CPR, highlighting its importance. End-of-life planning is a complex yet necessary decision that requires qualitative exploration with elderly, their families and care providers. |
| first_indexed | 2024-03-08T03:29:13Z |
| format | Article |
| id | doaj.art-49cbbafcbb5f4546b233b8cb18681a63 |
| institution | Directory Open Access Journal |
| issn | 2666-5204 |
| language | English |
| last_indexed | 2024-04-24T18:47:17Z |
| publishDate | 2024-03-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Resuscitation Plus |
| spelling | doaj.art-49cbbafcbb5f4546b233b8cb18681a632024-03-27T04:53:08ZengElsevierResuscitation Plus2666-52042024-03-0117100573Increasing neurologically intact survival after out-of-hospital cardiac arrest among elderly: Singapore ExperienceChloe Alexis Ong0Gayathri Devi Nadarajan1Stephanie Fook-Chong2Nur Shahidah3Shalini Arulanandam4Yih Yng Ng5Michael YC Chia6Ling Tiah7Desmond R Mao8Wei Ming Ng9Benjamin SH Leong10Nausheen Doctor11Marcus EH Ong12Fahad J Siddiqui13Lee Kong Chian School of Medicine, Nanyang Technological University of Singapore, SingaporeDepartment of Emergency Medicine, Singapore General Hospital, SingaporePre-hospital & Emergency Research Centre, Duke-NUS Medical School, SingaporeDepartment of Emergency Medicine, Singapore General Hospital, Singapore; Pre-hospital & Emergency Research Centre, Duke-NUS Medical School, Singapore; Corresponding author at: Department of Emergency Medicine Singapore General Hospital Outram Road, Singapore 169608, Singapore.Military Medicine Institute, Singapore Armed Forces Medical Corps, SingaporeLee Kong Chian School of Medicine, Nanyang Technological University of Singapore, Singapore; Digital and Smart Health Office, Ng Teng Fong Centre for Healthcare Innovation, Tan Tock Seng Hospital, Singapore; Department of Preventive and Population Medicine, Tan Tock Seng Hospital, SingaporeEmergency Department, Tan Tock Seng Hospital, SingaporeAccident & Emergency, Changi General Hospital, SingaporeDepartment of Acute and Emergency Care, Khoo Teck Puat Hospital, SingaporeEmergency Medicine Department, Ng Teng Fong General Hospital, SingaporeEmergency Medicine Department, National University Hospital, SingaporeDepartment of Emergency Medicine, Sengkang General Hospital, SingaporeDepartment of Emergency Medicine, Singapore General Hospital, Singapore; Health Services & Systems Research, Duke-NUS Medical School, SingaporePre-hospital & Emergency Research Centre, Duke-NUS Medical School, SingaporeObjectives: With more elderly presenting with Out-of-Hospital Cardiac Arrests (OHCAs) globally, neurologically intact survival (NIS) should be the aim of resuscitation. We aimed to study the trend of OHCA amongst elderly in a large Asian registry to identify if age is independently associated with NIS and factors associated with NIS. Methods: All adult OHCAs aged ≥18 years attended by emergency medical services (EMS) from April 2010 to December 2019 in Singapore was extracted from the Pan-Asian Resuscitation Outcomes Study (PAROS) registry. Cases pronounced dead at scene, non-EMS transported, traumatic OHCAs and OHCAs in ambulances were excluded. Patient characteristics and outcomes were compared across four age categories (18–64, 65–79, 80–89, ≥90). Multivariable logistic regression analysis determined the factors associated with NIS. Results: 19,519 eligible cases were analyzed. OHCA incidence increased with age almost doubling in octogenarians (from 312/100,000 in 2011 to 652/100,000 in 2019) and tripling in those ≥90 years (from 458/100,000 in 2011 to 1271/100,000 in 2019). The proportion of patients with NIS improved over time for the 18–64, 65–79- and 80–89-years age groups, with the greatest improvement in the youngest group. NIS decreased with each increasing year of age and minute of response time. NIS increased in the arrests of presumed cardiac etiology, witnessed and bystander CPR. Conclusions: Survival with good outcomes has increased even amongst the elderly. Regardless of age, NIS is possible with good-quality CPR, highlighting its importance. End-of-life planning is a complex yet necessary decision that requires qualitative exploration with elderly, their families and care providers.http://www.sciencedirect.com/science/article/pii/S2666520424000249ElderlyOut-of-hospital cardiac arrestQuality of lifeEpidemiologyCardiopulmonary resuscitation |
| spellingShingle | Chloe Alexis Ong Gayathri Devi Nadarajan Stephanie Fook-Chong Nur Shahidah Shalini Arulanandam Yih Yng Ng Michael YC Chia Ling Tiah Desmond R Mao Wei Ming Ng Benjamin SH Leong Nausheen Doctor Marcus EH Ong Fahad J Siddiqui Increasing neurologically intact survival after out-of-hospital cardiac arrest among elderly: Singapore Experience Resuscitation Plus Elderly Out-of-hospital cardiac arrest Quality of life Epidemiology Cardiopulmonary resuscitation |
| title | Increasing neurologically intact survival after out-of-hospital cardiac arrest among elderly: Singapore Experience |
| title_full | Increasing neurologically intact survival after out-of-hospital cardiac arrest among elderly: Singapore Experience |
| title_fullStr | Increasing neurologically intact survival after out-of-hospital cardiac arrest among elderly: Singapore Experience |
| title_full_unstemmed | Increasing neurologically intact survival after out-of-hospital cardiac arrest among elderly: Singapore Experience |
| title_short | Increasing neurologically intact survival after out-of-hospital cardiac arrest among elderly: Singapore Experience |
| title_sort | increasing neurologically intact survival after out of hospital cardiac arrest among elderly singapore experience |
| topic | Elderly Out-of-hospital cardiac arrest Quality of life Epidemiology Cardiopulmonary resuscitation |
| url | http://www.sciencedirect.com/science/article/pii/S2666520424000249 |
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