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Jonsson H, Piscator E, Boström AM, Djärv T. Neurological function before and after an in-hospital cardiac arrest - A nationwide registry-based cohort study. Resuscitation 2024; 201:110284. [PMID: 38901664 DOI: 10.1016/j.resuscitation.2024.110284] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2024] [Revised: 05/18/2024] [Accepted: 06/11/2024] [Indexed: 06/22/2024]
Abstract
BACKGROUND According to the Utstein Registry Template for in-hospital cardiac arrest (IHCA), a good neurological outcome is defined as either Cerebral Performance Category (CPC) 1-2 at discharge from hospital or unchanged CPC compared to baseline. However, the latter alternative has rarely been described in IHCA. This study aimed to examine CPC at admission to hospital, the occurrence of post-arrest neurological deterioration, and the factors associated with such deterioration. METHODS We studied adult IHCA survivors registered in the Swedish Registry of Cardiopulmonary Resuscitation between 2007 and 2022. The CPC was assessed based on information from admission and discharge from hospital. The data were analyzed using descriptive statistics and significance tests. RESULTS One in ten IHCA had a CPC score > 1 at admission to hospital. Out of 7,677 IHCA who survived until hospital discharge and had full CPC data, 6,774 (88%) had preserved CPC, 150 (2%) had improved CPC, and 753 (10%) had deteriorated CPC. Among the factors significantly associated with deteriorated neurological function are IHCA in a general ward or intensive care unit, non-shockable rhythm, no ECG surveillance, and a higher proportion of intra-arrest and post-resuscitation treatments (all p-values < 0,05). CONCLUSION Most patients had preserved neurological function compared to admission. Factors associated with deteriorated neurological function are mainly concordant with established risk factors for adverse outcomes and are primarily intra-arrest and post-resuscitation, making deterioration hard to predict. Further, every tenth survivor was admitted with CPC more than 1, stressing the use of unchanged CPC as an outcome in IHCA.
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Affiliation(s)
- Hanna Jonsson
- Department of Medicine Solna, Karolinska Institutet, Stockholm, Sweden; Medical Unit Aging, Theme Inflammation and Aging, Karolinska University Hospital, Stockholm, Sweden.
| | - Eva Piscator
- Department of Medicine Solna, Karolinska Institutet, Stockholm, Sweden; Department of Emergency Medicine, Capio S:t Görans Hospital, Stockholm, Sweden
| | - Anne-Marie Boström
- Medical Unit Aging, Theme Inflammation and Aging, Karolinska University Hospital, Stockholm, Sweden; Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden; Research and Development Unit, Stockholms Sjukhem, Stockholm, Sweden
| | - Therese Djärv
- Department of Medicine Solna, Karolinska Institutet, Stockholm, Sweden; Medical Unit Acute/ Emergency Department, Karolinska University Hospital, Stockholm, Sweden
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Ueno R, Reddy MP, Jones D, Pilcher D, Subramaniam A. The impact of frailty on survival times up to one year among patients admitted to ICU with in-hospital cardiac arrest. J Crit Care 2024; 83:154842. [PMID: 38865757 DOI: 10.1016/j.jcrc.2024.154842] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2023] [Revised: 04/18/2024] [Accepted: 06/06/2024] [Indexed: 06/14/2024]
Abstract
BACKGROUND In-hospital cardiac arrest (IHCA) is a serious medical emergency. When IHCA occurs in patients with frailty, short-term survival is poor. However, the impact of frailty on long-term survival is unknown. METHODS We performed a retrospective multicentre study of all critically ill adult (age ≥ 16 years) patients admitted to Australian intensive care units (ICU) between 1st January 2018 to 31st March 2022. We included all patients who had an IHCA within the 24 h before ICU admission with a documented Clinical Frail Scale (CFS). The primary outcome was median survival up to one year following ICU admission. The effect of frailty on one-year survival was assessed using a Cox proportional hazards model, adjusting for age, sex, comorbidities, sequential organ failure assessment (SOFA) score, and hospital type. RESULTS We examined 3769 patients, of whom 30.8% (n = 1160) were frail (CFS ≥ 5). The median survival was significantly shorter for patients with frailty (median [IQR] days 19 [1-365] vs 302 [9-365]; p < 0.001). The overall one-year mortality was worse for the patients with frailty when compared to the non-frail group (64.8% [95%CI 61.9-67.5] vs 36.4% [95%CI 34.5-38.3], p < 0.001). Each unit increment in the CFS was associated with 22% worse survival outcome (adjusted Hazard ratio = 1.22, 95%-CI 1.19-1.26), after adjustment for confounders. The survival trend was similar among patients who survived the hospitalization. CONCLUSION In this retrospective multicentre study, frailty was associated with poorer one-year survival in patients admitted to Australian ICUs following an IHCA.
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Affiliation(s)
- Ryo Ueno
- Intensive Care Medicine, Eastern Health, Victoria, Australia; Australian and New Zealand Intensive Care Research Centre, Monash University, Victoria, Australia.
| | - Mallikarjuna Ponnapa Reddy
- Intensive Care Medicine, Peninsula Health, Victoria, Australia; Intensive Care Medicine, Calvary Hospital Health, Canberra, Australia
| | - Daryl Jones
- Australian and New Zealand Intensive Care Research Centre, Monash University, Victoria, Australia; Intensive Care Medicine, Austin Health, Victoria, Australia; University of Melbourne, Victoria, Australia
| | - David Pilcher
- Australian and New Zealand Intensive Care Research Centre, Monash University, Victoria, Australia; Intensive Care Medicine, Alfred Health, Victoria, Australia; Australian and New Zealand Intensive Care Society (ANZICS) Centre for Outcome and Resources Evaluation, Victoria, Australia
| | - Ashwin Subramaniam
- Australian and New Zealand Intensive Care Research Centre, Monash University, Victoria, Australia; Intensive Care Medicine, Peninsula Health, Victoria, Australia; Intensive Care Medicine, Monash Health, Victoria, Australia; Monash University, Peninsula Clinical School, Victoria, Australia
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Strömsöe A, Herlitz J. Incidence and percentage of survival after cardiac arrest outside and inside hospital: A comparison between two regions in Sweden. Resusc Plus 2024; 17:100594. [PMID: 38469565 PMCID: PMC10926284 DOI: 10.1016/j.resplu.2024.100594] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/13/2024] Open
Abstract
Aim To compare the incidence and percentage of survival after cardiac arrest outside and inside hospital where cardiopulmonary resuscitation (CPR) had been started between two regions in Sweden in a 10-year perspective. Methods A retrospective observational study including CPR treated patients both after out-of-hospital and in-hospital cardiac arrest (OHCA and IHCA) in Sweden, 2013-2022. Data was retrieved from the Swedish Registry of Cardiopulmonary Resuscitation (SRCR). Results The overall incidence of OHCA and IHCA events were 2,940 in Dalarna (having a lower population and population density) and 16,187 in Västra Götaland (having a higher population and population density). The overall incidence of survival when OHCA and IHCA were combined was 20 per 100,000 person years in Dalarna and 19 per 100,000 person years in Västra Götaland. The corresponding result for OHCA was 9 versus 7 and for IHCA 11 versus 12. The overall percentage of survival was 20% in Dalarna and 19% in Västra Götaland. The corresponding result for OHCA was 13% versus 10% and for IHCA 37% versus 36%. Conclusion Overall, there was no marked difference neither in incidence nor in percentage of survival after cardiac arrest between the two regions. However, regarding cardiac arrest that took place outside hospital both incidence and percentage of survival was higher in Dalarna than in Västra Götaland despite the fact that the former had lower population density.
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Affiliation(s)
- A. Strömsöe
- School of Health and Welfare, Dalarna University, S-79188 Falun, Sweden
- Center for Clinical Research Dalarna, Uppsala University, S-79182 Falun, Sweden
- Department of Prehospital Care, Region of Dalarna, S-79129 Falun, Sweden
| | - J. Herlitz
- Department of Caring Science, University of Borås, S-50190 Borås, Sweden
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Liew CQ, Chen YC, Sung CW, Ko CH, Ku NW, Huang CH, Cheng MT, Tsai CL. A novel scale for triage assessment of frailty in the emergency department (ED-FraS): a prospective videotaped study. BMC Geriatr 2024; 24:137. [PMID: 38321397 PMCID: PMC10848459 DOI: 10.1186/s12877-024-04724-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2023] [Accepted: 01/18/2024] [Indexed: 02/08/2024] Open
Abstract
BACKGROUND Rapid recognition of frailty in older patients in the ED is an important first step toward better geriatric care in the ED. We aimed to develop and validate a novel frailty assessment scale at ED triage, the Emergency Department Frailty Scale (ED-FraS). METHODS We conducted a prospective cohort study enrolling adult patients aged 65 years or older who visited the ED at an academic medical center. The entire triage process was recorded, and triage data were collected, including the Taiwan Triage and Acuity Scale (TTAS). Five physician raters provided ED-FraS levels after reviewing videos. A modified TTAS (mTTAS) incorporating ED-FraS was also created. The primary outcome was hospital admission following the ED visit, and secondary outcomes included the ED length of stay (EDLOS) and total ED visit charges. RESULTS A total of 256 patients were included. Twenty-seven percent of the patients were frail according to the ED-FraS. The majority of ED-FraS was level 2 (57%), while the majority of TTAS was level 3 (81%). There was a weak agreement between the ED-FraS and TTAS (kappa coefficient of 0.02). The hospital admission rate and charge were highest at ED-FraS level 5 (severely frail), whereas the EDLOS was longest at level 4 (moderately frail). The area under the Receiver Operating Characteristic curve (AUROC) in predicting hospital admission for the TTAS, ED-FraS, and mTTAS were 0.57, 0.62, and 0.63, respectively. The ED-FraS explained more variation in EDLOS (R2 = 0.096) compared with the other two methods. CONCLUSIONS The ED-Fras tool is a simple and valid screening tool for identifying frail older adults in the ED. It also can complement and enhance ED triage systems. Further research is needed to test its real-time use at ED triage internationally.
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Affiliation(s)
- Chiat Qiao Liew
- Department of Emergency Medicine, National Taiwan University Hospital, Taipei, Taiwan
| | - Yun Chang Chen
- Department of Emergency Medicine, National Taiwan University Hospital Yun-Lin Branch, Hsinchu, Taiwan
| | - Chih-Wei Sung
- Department of Emergency Medicine, College of Medicine, National Taiwan University, Taipei, Taiwan
- Department of Emergency Medicine, National Taiwan University Hospital Hsin-Chu Branch, Hsinchu, Taiwan
| | - Chia-Hsin Ko
- Department of Emergency Medicine, National Taiwan University Hospital, Taipei, Taiwan
| | - Nai-Wen Ku
- Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, Toronto, Canada
| | - Chien-Hua Huang
- Department of Emergency Medicine, National Taiwan University Hospital, Taipei, Taiwan
- Department of Emergency Medicine, College of Medicine, National Taiwan University, Taipei, Taiwan
| | - Ming-Tai Cheng
- Department of Emergency Medicine, College of Medicine, National Taiwan University, Taipei, Taiwan.
- Department of Emergency Medicine, National Taiwan University Hospital Yun-Lin Branch, Hsinchu, Taiwan.
| | - Chu-Lin Tsai
- Department of Emergency Medicine, National Taiwan University Hospital, Taipei, Taiwan.
- Department of Emergency Medicine, College of Medicine, National Taiwan University, Taipei, Taiwan.
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Piscator E, Djarv T. To withhold resuscitation - The Swedish system's rules and challenges. Resusc Plus 2023; 16:100501. [PMID: 38026137 PMCID: PMC10665955 DOI: 10.1016/j.resplu.2023.100501] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2023] Open
Abstract
The aim of this article is to describe current Swedish legalisation, clinical practice and future perspectives on the medical ethical decision "Do-Not-Attempt-Cardio-Pulmonary-Resuscitation" (DNACPR) in relation to prevent futile resuscitation of in-hospital cardiac arrests. Sweden has about 2200 in-hospital cardiac arrests yearly, with an overall 30-day survival ratio of 35%. This population is highly selected, although the frequency of DNACPR orders for hospitalized patients is unknown, resuscitation is initiated in only 6-13% of patients dying in Swedish hospitals. According to Swedish law and although shared decision making is sought, the physician is the ultimate decision-maker and consultation with the patient, her relatives and another licenced health care practitioner is mandatory. According to studies, these consultations is documented in only about 10% of the decisions. Clinicians lack tools to assess risk of IHCA, tools to predict outcome and we are not good at guessing patients own will. Future directives for clinical practice need to address difficulties for physicians in making decisions as well as the timing of decisions. We conclude that the principles in Swedish law needs to be fulfilled by a more systematic approach to documentation and planning of meetings between patients, relatives and colleagues.
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Affiliation(s)
- Eva Piscator
- Department of Medicine Solna, Karolinska Institutet, Stockholm, Sweden
- Emergency Department, Capio Sankt Görans Hospital, Stockholm, Sweden
| | - Therese Djarv
- Department of Medicine Solna, Karolinska Institutet, Stockholm, Sweden
- Emergency Department, Karolinska University Hospital, Stockholm, Sweden
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Kim B, Hong SI, Kim YJ, Cho YJ, Kim WY. Predicting the probability of good neurological outcome after in-hospital cardiac arrest based on prearrest factors: validation of the good outcome following attempted resuscitation 2 (GO-FAR 2) score. Intern Emerg Med 2023; 18:1807-1813. [PMID: 37115419 DOI: 10.1007/s11739-023-03271-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/31/2023] [Accepted: 03/31/2023] [Indexed: 04/29/2023]
Abstract
The Good Outcome Following Attempted Resuscitation (GO-FAR) 2 score is a prognostic tool developed to support decision-making for do-not-attempt-resuscitation (DNAR) orders by predicting neurological outcomes after in-hospital cardiac arrest (IHCA) based on prearrest variables. However, this scoring system requires further validation. We aimed to validate the GO-FAR 2 score for predicting good neurological outcome in Korean patients with IHCA. A single-centre registry of adult patients with IHCA from 2013 to 2017 was analysed. The primary outcome was discharge with good neurological outcome (Cerebral Performance Category score of 1 or 2). The patients were divided into four categories according to the GO-FAR 2 score: very poor (≥ 5), poor (2-4), average (- 3 to 1), and above-average (< - 3) likelihood of good neurological outcome. Of 1,011 patients (median age, 65 years), 63.1% were men. The rate of good neurological outcome was 16.0%. The proportions of patients categorised as having very poor, poor, average, and above-average probability of good neurological outcome were 3.9%, 18.3%, 70.2%, and 7.6%, respectively. In each category, good neurological outcome was observed in 0%, 1.1%, 16.8%, and 53.2%, respectively. Among patients in below-average categories (very poor + poor, GO-FAR 2 score ≥ 2), only 0.9% had good outcome. GO-FAR 2 score ≥ 2 showed a sensitivity of 98.8% and a negative predictive value of 99.1% in predicting good neurological outcome. The GO-FAR 2 score can predict neurological outcome after IHCA. In particular, GO-FAR 2 score ≥ 2 may support decision-making for DNAR orders.
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Affiliation(s)
- Boram Kim
- Department of Emergency Medicine, Asan Medical Center, Ulsan University College of Medicine, Seoul, 05505, Korea
| | - Seok-In Hong
- Department of Emergency Medicine, Asan Medical Center, Ulsan University College of Medicine, Seoul, 05505, Korea
| | - Youn-Jung Kim
- Department of Emergency Medicine, Asan Medical Center, Ulsan University College of Medicine, Seoul, 05505, Korea
| | - Yeon Joo Cho
- Department of Emergency Medicine, Kyungpook National University School of Medicine, Daegu, Korea
| | - Won Young Kim
- Department of Emergency Medicine, Asan Medical Center, Ulsan University College of Medicine, Seoul, 05505, Korea.
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Yamamoto R, Tamura T, Haiden A, Yoshizawa J, Homma K, Kitamura N, Sugiyama K, Tagami T, Yasunaga H, Aso S, Takeda M, Sasaki J. Frailty and Neurologic Outcomes of Patients Resuscitated From Nontraumatic Out-of-Hospital Cardiac Arrest: A Prospective Observational Study. Ann Emerg Med 2023; 82:84-93. [PMID: 36964008 DOI: 10.1016/j.annemergmed.2023.02.009] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2022] [Revised: 02/01/2023] [Accepted: 02/09/2023] [Indexed: 03/26/2023]
Abstract
STUDY OBJECTIVE To elucidate the clinical utility of the Clinical Frailty Scale score for predicting poor neurologic functions in patients resuscitated from out-of-hospital cardiac arrest (OHCA). METHODS This was a prospective, multicenter, observational study conducted between 2019 and 2021. The study included adults with nontraumatic OHCA admitted to the intensive care unit after return of spontaneous circulation (ROSC). Pre-arrest high Clinical Frailty Scale score was defined as 5 or more. Favorable neurologic outcomes defined as a Cerebral Performance Category score of 2 or less at 30 days after admission were compared between patients with and without high Clinical Frailty Scale scores. Multivariable logistic regression analyses fitted with generalized estimating equations were performed to adjust for patient characteristics, out-of-hospital information, and resuscitation content and account for within-institution clustering. RESULTS Of 9,909 patients with OHCA during the study period, 1,216 were included, and 317 had a pre-arrest high Clinical Frailty Scale score. Favorable neurologic outcomes were fewer among patients with high Clinical Frailty Scale scores. The high Clinical Frailty Scale score group showed a lower percentage of favorable neurologic outcomes after OHCA than the low Clinical Frailty Scale score group (6.1% vs 24.4%; adjusted odds ratio, 0.45 [95% confidence interval 0.22 to 0.93]). This relationship remained in subgroups with cardiogenic OHCA, with ROSC after hospital arrival, and without a high risk of dying (Clinical Frailty Scale score of 7 or less), whereas the neurologic outcomes were comparable regardless of pre-arrest frailty in those with noncardiogenic OHCA and with ROSC before hospital arrival. CONCLUSIONS Pre-arrest high Clinical Frailty Scale score was associated with unfavorable neurologic functions among patients resuscitated from OHCA. The Clinical Frailty Scale score would help predict clinical consequences following intensive care after ROSC.
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Affiliation(s)
- Ryo Yamamoto
- Department of Emergency and Critical Care Medicine, Keio University School of Medicine, Tokyo, Japan.
| | - Tomoyoshi Tamura
- Department of Emergency and Critical Care Medicine, Keio University School of Medicine, Tokyo, Japan
| | - Akina Haiden
- Department of Emergency and Critical Care Medicine, Keio University School of Medicine, Tokyo, Japan
| | - Jo Yoshizawa
- Department of Emergency and Critical Care Medicine, Keio University School of Medicine, Tokyo, Japan
| | - Koichiro Homma
- Department of Emergency and Critical Care Medicine, Keio University School of Medicine, Tokyo, Japan
| | - Nobuya Kitamura
- Department of Emergency and Critical Care Medicine, Kimitsu Chuo Hospital, Chiba, Japan
| | - Kazuhiro Sugiyama
- Tertiary Emergency Medical Center, Tokyo Metropolitan Bokutoh Hospital, Tokyo, Japan
| | - Takashi Tagami
- Department of Emergency and Critical Care Medicine, Nippon Medical School Musashikosugi Hospital, Kanagawa, Japan
| | - Hideo Yasunaga
- Department of Clinical Epidemiology and Health Economics, School of Public Health, The University of Tokyo, Tokyo, Japan
| | - Shotaro Aso
- Department of Biostatistics and Bioinformatics, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Munekazu Takeda
- Department of Critical Care and Emergency Medicine, Tokyo Women's Medical University, Tokyo, Japan
| | - Junichi Sasaki
- Department of Emergency and Critical Care Medicine, Keio University School of Medicine, Tokyo, Japan
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Ohbe H, Nakajima M, Miyamoto Y, Shibahashi K, Matsui H, Yasunaga H, Sasabuchi Y. 1-year functional outcomes after cardiopulmonary resuscitation for older adults with pre-existing long-term care needs. Age Ageing 2023; 52:7181243. [PMID: 37247400 DOI: 10.1093/ageing/afad072] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2023] [Indexed: 05/31/2023] Open
Abstract
OBJECTIVE To investigate the 1-year functional outcomes after cardiopulmonary resuscitation (CPR) in adults aged ≥65 years with pre-existing long-term care needs. METHODS This population-based cohort study was conducted in Tochigi Prefecture, one of 47 prefectures in Japan. We used medical and long-term care administrative databases, which included data on functional and cognitive impairment that were assessed with the nationally standardised care-needs certification system. Among individuals aged ≥65 years registered between June 2014 and February 2018, patients who underwent CPR were identified. The primary outcome was mortality and care needs at 1 year after CPR. The outcome was stratified by pre-existing care needs before CPR based on the total daily estimated care minutes: no care needs, support levels 1 and 2 and care-needs level 1 (estimated care time 25-49 min), care-needs levels 2 and 3 (50-89 min) and care-needs levels 4 and 5 (≥90 min). RESULTS Among 594,092 eligible individuals, 5,086 (0.9%) underwent CPR. The 1-year mortalities after CPR in patients with no care needs, support levels 1 and 2 and care-needs level 1, care-needs levels 2 and 3 and care-needs levels 4 and 5 were 94.6% (n = 2,207/2,332), 96.1% (n = 736/766), 94.5% (n = 930/984) and 95.9% (n = 963/1,004), respectively. Among survivors, most patients had no change in care needs before and at 1 year after CPR. There was no significant association between pre-existing functional and cognitive impairment and 1-year mortality and care needs after adjusting for potential confounders. CONCLUSION Healthcare providers need to discuss poor survival outcomes after CPR with all older adults and their families in shared decision making.
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Affiliation(s)
- Hiroyuki Ohbe
- Department of Clinical Epidemiology and Health Economics, School of Public Health, The University of Tokyo, Tokyo 113-0033, Japan
| | - Mikio Nakajima
- Department of Clinical Epidemiology and Health Economics, School of Public Health, The University of Tokyo, Tokyo 113-0033, Japan
- Emergency Life-Saving Technique Academy of Tokyo, Foundation for Ambulance Service Development, Tokyo 192-0364, Japan
- Emergency and Critical Care Center, Tokyo Metropolitan Hiroo Hospital, Tokyo 150-0013, Japan
| | - Yuki Miyamoto
- Department of Emergency Medicine, Kyoto Prefectural University of Medicine, Kyoto 602-8566, Japan
| | - Keita Shibahashi
- Department of Clinical Epidemiology and Health Economics, School of Public Health, The University of Tokyo, Tokyo 113-0033, Japan
- Tertiary Emergency Medical Center, Tokyo Metropolitan Bokutoh Hospital, Tokyo 130-8575, Japan
| | - Hiroki Matsui
- Department of Clinical Epidemiology and Health Economics, School of Public Health, The University of Tokyo, Tokyo 113-0033, Japan
| | - Hideo Yasunaga
- Department of Clinical Epidemiology and Health Economics, School of Public Health, The University of Tokyo, Tokyo 113-0033, Japan
| | - Yusuke Sasabuchi
- Data Science Center, Jichi Medical University, Tochigi 329-0431, Japan
- Department of Read World Evidence, Graduate School of Medicine, The University of Tokyo, Tokyo 113-0033, Japan
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Mercier E, Mowbray FI. Patient-important outcomes following in-hospital cardiac arrest: Using frailty to move beyond prediction of immediate survival. Resuscitation 2022; 179:38-40. [PMID: 35933058 DOI: 10.1016/j.resuscitation.2022.07.037] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2022] [Accepted: 07/28/2022] [Indexed: 11/17/2022]
Affiliation(s)
- Eric Mercier
- VITAM - Centre de recherche en santé durable de l'Université Laval, Québec, Canada; Axe Santé des Populations et Pratiques Optimales en Santé, Unité de recherche en Traumatologie - Urgence - Soins Intensifs, Centre de recherche du CHU de Québec, Université Laval, Québec, Canada; Département de médecine familiale et médecine d'urgence, Faculté de Médecine, Université Laval, Québec, Canada.
| | - Fabrice I Mowbray
- Department of Health Research Methods, Evidence, and Impact, McMaster University, Canada
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