医学
心肺复苏术
共病
重症监护医学
复苏
人口
流行病学
内科学
急诊医学
环境卫生
作者
Sharon Einav,Andrea Cortegiani,Esther‐Lee Marcus
出处
期刊:Current Opinion in Anesthesiology
[Ovid Technologies (Wolters Kluwer)]
日期:2021-02-01
卷期号:34 (1): 40-47
被引量:6
标识
DOI:10.1097/aco.0000000000000942
摘要
To describe the epidemiology, prognostication, and treatment of out- and in-hospital cardiac arrest (OHCA and IHCA) in elderly patients.Elderly patients undergoing cardiac arrest (CA) challenge the appropriateness of attempting cardiopulmonary resuscitation (CPR). Current literature suggests that factors traditionally associated with survival to hospital discharge and neurologically intact survival after CA cardiac arrest in general (e.g. presenting ryhthm, bystander CPR, targeted temperature management) may not be similarly favorable in elderly patients. Alternative factors meaningful for outcome in this special population include prearrest functional status, comorbidity load, the specific age subset within the elderly population, and CA location (i.e., nursing versus private home). Age should therefore not be a standalone criterion for withholding CPR. Attempts to perform CPR in an elderly patient should instead stem from a shared decision-making process.An appropriate CPR attempt is an attempt resulting in neurologically intact survival. Appropriate CPR in elderly patients requires better risk classification. Future research should therefore focus on the associations of specific within-elderly age subgroups, comorbidities, and functional status with neurologically intact survival. Reporting must be standardized to enable such evaluation.
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