Association between age and neurological outcomes in out-of-hospital cardiac arrest patients resuscitated with extracorporeal cardiopulmonary resuscitation: a nationwide multicentre observational study
Association between age and neurological outcomes in out-of-hospital cardiac arrest patients resuscitated with extracorporeal cardiopulmonary resuscitation: a nationwide multicentre observational study
复制标题
DOI：
10.1093/ehjacc/zuab021
复制
发表时间：
2021-04-21
影响因子：
4.1
通讯作者：
Ohta, Bon
中科院分区：
文献类型：
--
作者：
Miyamoto, Yuki;Matsuyama, Tasuku;Ohta, Bon
对于院外心脏骤停（OHCA）接受体外心肺复苏（ECPR）的年轻和老年患者的结局差异知之甚少。因此，我们的目的是调查年龄≥ 75岁和≥ 18岁的OHCA患者接受ECPR的结局差异。将患者分为三个年龄组（18-59岁、60-74岁和≥ 75岁）。主要结局为1个月神经学结局。为了研究年龄和1个月神经学结果之间的关系，我们用广义估计方程进行了logistic回归分析。从2014年到2017年，我们确定了875名年龄≥ 18岁的OHCA患者接受了ECPR。在18-59岁、60-74岁和≥ 75岁的患者中，存活且神经系统结局良好的患者比例分别为15%（64/434）、8.9%（29/326）和1.7%（2/115）。在多变量分析中，与18-59岁年龄组相比，60-74岁年龄组患者的神经功能预后良好的比例显著较低[校正比值比（OR），0.44; 95%置信区间（CI），0.32-0.61]，而年龄≥ 75岁的患者结论高龄（尤其是≥ 75岁）OHCA患者接受ECPR治疗后神经功能预后差。[图形]
Aims Little is known about the difference in outcomes between young and old patients who received extracorporeal cardiopulmonary resuscitation (ECPR) for out-of-hospital cardiac arrest (OHCA). Therefore, we aimed to investigate the differences in outcomes between those aged >= 75 years and = 18 years with OHCA who received ECPR. The patients were classified into three age groups (18-59 years, 60-74 years, and >= 75 years). The primary outcome was a 1-month neurological outcome. To examine the association between age and 1-month neurological outcome, we performed logistic regression analyses fitted with generalized estimating equations. From 2014 to 2017, we identified 875 OHCA patients aged >= 18 years who received ECPR. The proportion of patients who survived with favourable neurological outcome in the patients aged 18-59 years, 60-74 years, and >= 75 years were 15% (64/434), 8.9% (29/326), and 1.7% (2/115), respectively. In the multivariable analysis, compared with the age of 18-59 years, the proportions of favourable neurological outcomes were significantly lower in patients aged 60-74 years [adjusted odds ratio (OR), 0.44; 95% confidence interval (CI), 0.32-0.61] and those aged >= 75 years (adjusted OR, 0.26; 95% CI, 0.11-0.59).Conclusion Advanced age (age >= 75 years in particular) was significantly associated with poor neurological outcomes in patients with OHCA who received ECPR.[GRAPHICS]