Characteristics and outcome among 14,933 adult cases of in-hospital cardiac arrest: A nationwide study with the emphasis on gender and age

• Published in: The American journal of emergency medicine 2017-12, Vol.35 (12), p.1839-1844
• Main Authors: Al-Dury, Nooraldeen, MD, Rawshani, Araz, MD PhD, Israelsson, Johan, RN PhD, Strömsöe, Anneli, RN PhD, Aune, Solveig, RN PhD, Agerström, Jens, Karlsson, Thomas, B. Sc, Ravn-Fischer, Annica, MD PhD, Herlitz, Johan
• Format: Article
• Language: English
• Subjects: Age; Angina pectoris; Cardiac arrest; Cardiopulmonary resuscitation; Cerebral blood flow; Clinical Medicine; Councils; CPR; Emergency; Emergency medical care; Etiology; Family medical history; Gender differences; Heart; Heart attacks; Heart diseases; Heart failure; Ischemia; Klinisk medicin; Medical prognosis; Medicin; Medicine; Mens health; Morbidity; Myocardial infarction; Människan i vården; Renal function; Stroke; Survival; Women
• ISSN: 0735-6757; 1532-8171; 1532-8171
• DOI: 10.1016/j.ajem.2017.06.012

Abstract Aim To investigate characteristics and outcome among patients suffering in-hospital cardiac arrest (IHCA) with the emphasis on gender and age. Methods Using the Swedish Register of Cardiopulmonary Resuscitation, we analyzed associations between gender, age and co-morbidities, etiology, management, 30-day survival and cerebral function among survivors in 14,933 cases of IHCA. Age was divided into three ordered categories: young (18–49 years), middle-aged (50–64 years) and older (65 years and above). Comparisons between men and women were age adjusted. Results The mean age was 72.7 years and women were significantly older than men. Renal dysfunction was the most prevalent co-morbidity. Myocardial infarction/ischemia was the most common condition preceding IHCA, with men having 27% higher odds of having MI as the underlying etiology. A shockable rhythm was found in 31.8% of patients, with men having 52% higher odds of being found in VT/VF. After adjusting for various confounders, it was found that men had a 10% lower chance than women of surviving to 30 days. Older individuals were managed less aggressively than younger patients. Increasing age was associated with lower 30-day survival but not with poorer cerebral function among survivors. Conclusion When adjusting for various confounders, it was found that men had a 10% lower chance than women of surviving to 30 days after in-hospital cardiac arrest. Older individuals were managed less aggressively than younger patients, despite a lower chance of survival. Higher age was, however, not associated with poorer cerebral function among survivors.