Abstract：
The likelihood of neurological recovery after out-of-hospital cardiac arrest (OHCA) may be influenced by advanced age. This study aims to evaluate the impact of advanced age on neurological recovery in elderly OHCA survivors treated with targeted temperature management (TTM). This retrospective observational study, using a nationwide population-based OHCA registry, was conducted from January 2016 to December 2020. Non-traumatic elderly (≥ 65 years) comatose OHCA survivors treated with TTM were categorized according to age (65-69, 70-74, 75-79, and ≥ 80 years). Among 23,336 admitted OHCA patients, 3,398 were treated with TTM. Excluding 2,033 non-elderly patients, 1,365 were analyzed. Among the four groups, the rate of good neurological outcomes decreased by advanced age (24.2%, 16.1%, 11.4%, and 5.9%, respectively), which was also observed after subgroup analysis based on the initial shockable (40.6%, 31.5%, 28.6%, and 14.9%, respectively) and non-shockable rhythm (10.6%, 7.2%, 4.1%, and 3.4%, respectively). Multivariate analysis showed the adjusted odds ratio (aOR) for good neurological outcome decreased as age increased (65-69: reference, 70-74: aOR 0.70, 75-79: aOR 0.49, and ≥ 80 years: aOR 0.25). The optimal age cutoffs for good outcomes in elderly OHCA survivors with shockable and non-shockable rhythm were 77 and 72 years, respectively. The neurologic recovery rate in OHCA survivors treated with TTM gradually decreased with increasing age. However, even patients aged ≥ 80 years with shockable rhythm had a good neurologic outcome of 14.9% compared with patients aged 65-69 years with non-shockable rhythm (10.6%).
摘要：
院外心脏骤停（OHCA）后神经系统恢复的可能性可能受到高龄的影响。这项研究旨在评估高龄对接受目标温度管理（TTM）治疗的老年OHCA幸存者神经系统恢复的影响。这项回顾性观察研究，使用基于全国人口的OHCA注册表，于2016年1月至2020年12月进行。接受TTM治疗的非创伤性老年（≥65岁）昏迷OHCA幸存者根据年龄（65-69、70-74、75-79和≥80岁）进行分类。在23,336名OHCA患者中，用TTM处理3,398。不包括2033名非老年患者，分析了1,365个。在四个群体中，神经系统预后良好的比率随着年龄的增长而下降(24.2%，16.1%,11.4%,和5.9%，分别)，在基于初始可电击的亚组分析后也观察到了这一点(40.6%，31.5%,28.6%,和14.9%，分别)和不可电击节律(10.6%，7.2%,4.1%,和3.4%，分别)。多变量分析显示，随着年龄的增加，神经系统预后良好的校正比值比（aOR）降低（65-69：参考，70-74：aOR0.70，75-79：aOR0.49，≥80岁：aOR0.25）。在具有可电击和不可电击节律的老年OHCA幸存者中，良好结局的最佳年龄截止为77岁和72岁，分别。接受TTM治疗的OHCA幸存者的神经系统恢复率随着年龄的增长而逐渐降低。然而,即使年龄≥80岁的可电击心律患者,与65-69岁的不可电击心律患者(10.6%)相比,其良好的神经系统结局为14.9%.
