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Cited by 41Cardiac Arrest and ResuscitationPalliative Care and End-of-Life IssuesMechanical Circulatory Support Devices

Improved survival with favorable neurological outcome in elderly individuals with out-of-hospital cardiac arrest in Japan – a nationwide observational cohort study

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Funada, Akira, Goto, Yoshikazu, Maeda, Tetsuo, Teramoto, Ryota, Hayashi, Kenshi, Yamagishi, Masakazu·2016·Circulation Journal
DOI 10.1253/circj.cj-15-1285
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Abstract

BACKGROUND: There is sparse data regarding the survival and neurological outcome of elderly patients with out-of-hospital cardiac arrest (OHCA). METHODS AND RESULTS: OHCA patients (334,730) aged ≥75 years were analyzed using a nationwide, prospective, population-based Japanese OHCA database from 2008 to 2012. The overall 1-month survival with favorable neurological outcome (Cerebral Performance Category Scale, category 1 or 2; CPC 1-2) rate was 0.88%. During the study period, the annual 1-month CPC 1-2 rate in whole OHCA significantly improved (0.73% to 0.96%, P for trend <0.001). In particular, outcomes of OHCA patients aged 75 to 84 years and those aged 85 to 94 years significantly improved (0.98% to 1.28%, P for trend=0.01; 0.46% to 0.70%, P for trend <0.001, respectively). However, in OHCA patients aged ≥95 years, the outcomes did not improve. Multivariate logistic regression analysis indicated that younger age, shockable first documented rhythm, witnessed arrest, earlier emergency medical service (EMS) response time, and cardiac etiology were significantly associated with the 1-month CPC 1-2. Under these conditions, elderly OHCA patients who had cardiac etiology, shockable rhythm and had a witnessed arrest had acceptable 1-month CPC1-2 rate; 7.98% in cases where OHCA was witnessed by family, 15.2% by non-family, and 25.6% by EMS. CONCLUSIONS: The annual 1-month CPC 1-2 rate after OHCA among elderly patients significantly improved, and the resuscitation of elderly patients in a selected population is not futile. (Circ J 2016; 80: 1153-1162).

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  • Putting parents in the position to forgo CPR may intensify parental grief and helplessness.

    “Importantly, putting for instance parents in the position to forgo CPR may intensify parental grief and helplessness. 148”

    From European Resuscitation Council Guidelines 2021: Ethics of resuscitation and end of life decisions (2021) · cites this paper as [148]

    The Further Improvements section discusses CPR performed by family witnesses and outcomes for elderly patients, not parents asked to forgo CPR. The Conclusions mention ethical complexity in end-of-life decisions but do not address parental grief or helplessness. Searches for those effects and for the emotional burden of foregoing resuscitation found no supporting passage in our copy. (LLM, conf=0.76)

    Experimental — accuracy not yet measured

  • The likelihood of truly informed unbiased consent during cardiac arrest is low, and it is unclear whether the best interest of the patient might conflict with the rights and interests of relatives.

    “Moreover, the likelihood of truly informed unbiased consent is low, and it is unclear whether the best interest of the patient might not conflict with the rights and interests of the relatives. 148”

    From European Resuscitation Council Guidelines 2021: Ethics of resuscitation and end of life decisions (2021) · cites this paper as [148]

    The Conclusions discuss ethical and legal complexity in end-of-life decisions but do not address the likelihood of unbiased consent or a possible conflict between patients’ and relatives’ interests. Data Collection and Quality Control discusses consent only for using anonymous research data. Searches for those consent and family-interest claims found no supporting passage in our copy. (LLM, conf=0.78)

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Cited by

Sorted by citations

Authors
Funada, A., Goto, Y., Maeda, T., Teramoto, R., Hayashi, K., & Yamagishi, M.
Affiliations
  • Kanazawa University (JP)
  • Kanazawa University Hospital (JP)
ORCID
Venue
Circulation Journal
Publisher
Japanese Circulation Society
Published
2016
Volume
80
Issue
5
Pages
1153-1162
ISSN
  • 1346-9843 (ISSN-L)
  • 1347-4820
DOI
10.1253/circj.cj-15-1285
OpenAlex
W2328709815
Cited by
41
References
0
Citations by year
2026: 4 · 2025: 2 · 2024: 3 · 2023: 1 · 2022: 3 · 2021: 4 · 2020: 1 · 2019: 6 · 2018: 7 · 2017: 4 · 2016: 5 · 2015: 1
FWCI
9.69
Type
journal article
Language
en
Open access
Locations
  • Circulation Journal (publishedVersion)
  • PubMed (publishedVersion)
  • Institutional Repositories DataBase (IRDB) (submittedVersion, cc-by-nc-nd)
  • Kanazawa University Repository for Academic Resources (DSpace) (Kanazawa University) (submittedVersion, cc-by-nc-nd)
Topics
  • Health Sciences › Medicine › Emergency Medicine › Cardiac Arrest and Resuscitation
  • Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Palliative Care and End-of-Life Issues
  • Physical Sciences › Engineering › Biomedical Engineering › Mechanical Circulatory Support Devices
Keywords
out-of-hospital cardiac arrest, elderly patients, neurological outcome, 1-month survival, cerebral performance category, resuscitation outcomes, shockable rhythm, witnessed arrest, cardiac etiology, age trends
MeSH terms
Age Factors, Aged, Aged, 80 and over, Humans, Japan, Nervous System Diseases, Prospective Studies, Cohort Studies, Survival Rate, Databases, Factual, Cardiopulmonary Resuscitation, Treatment Outcome, Out-of-Hospital Cardiac Arrest

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