PURPOSE: Patients who suffer cardiac arrest are reported to have a poor prognosis. Out of hospital(OH) versus In-hospital(IH) arrests, duration to return to spontaneous circulation(ROSC) and age are associated with increased mortality. However characteristics and outcomes in this group of patients are relatively less studied among the inner city minority population.
METHODS: A prospective observational study including all patients admitted with cardiac arrest to the ICU was performed from January 2005 to December 2007. Demographics, etiology of arrest, median time to ROSC, APACHE-II score and mortality were recorded from a centralized database. Univariate and multivariate logistic regression analysis was performed. Odds ratios and 95% CI are reported. A p-value of <0.05 was considered significant.
RESULTS: Among the 36 study subjects, 53% were men; median age was 63 years (Inter quartile range (IQR) 53.5 -71.5 yrs); and 39% were Hispanics. 72% of them were OH cardiac arrests. Median APACHE-II score on admission was 26.5(IQR 20–32). Median time to ROSC was 10 minutes(IQR 5 -20). 69.5% suffered primarily cardiac arrest, whereas 30.5% of them suffered respiratory arrest followed by cardiac arrest. On multivariate analysis, location and type of arrest, time to ROSC, APACHE II scores were not found to be significantly different between survivors and non-survivors. Median age among non-survivors (55.5 years,IQR 49–67 yrs) was noted to be significantly lower compared to survivors (68 years,IQR 64–76 yrs; OR 0.88 95%CI 0.79 –0.98, p-value < 0.05). When age-related differences were studied comparing geriatric subjects (>65 years of age) and younger adults, geriatric subjects (62.5%) had more survivors than younger adults (20%; OR 0.04, 95CI 0.002 –0.77, p < 0.05).
CONCLUSION: Geriatric subjects were found to have higher odds of survival than younger adults. These findings must be taken into account in triaging and management of individuals of all ages who suffer cardiac arrest and require admissions to ICU.
CLINICAL IMPLICATIONS: Older age among patients with cardiac arrests may not preclude admissions to MICU. Interestingly, time to ROSC does not reliably predict outcomes.
DISCLOSURE: Raghu Loganathan, No Financial Disclosure Information; No Product/Research Disclosure Information