Old age does not negate good cerebral outcome after cardiopulmonary resuscitation: analyses from the brain resuscitation clinical trials. The Brain Resuscitation Clinical Trial I and II Study Groups

Crit Care Med. 1995 Jan;23(1):18-25. doi: 10.1097/00003246-199501000-00007.

Abstract

Objective: To assess survival after cardiac arrest and to determine whether age is an independent determinant of late mortality or poor neurologic outcome.

Design: Analyses using results of Brain Resuscitation Clinical Trial I (1979 to 1984) and Brain Resuscitation Clinical Trial II (1984 to 1989), two randomized, double-blind studies of outcome following cardiac arrest.

Setting: A multicenter study in 12 acute care hospitals in nine countries (Brain Resuscitation Clinical Trial I), and 24 hospitals in eight countries (Brain Resuscitation Clinical Trial II).

Patients: A total of 774 patients who were initially comatose after successful resuscitation from cardiac arrest. The analyses include both in- and out-of-hospital cardiac arrests.

Results: The 6-month mortality rate for the entire group was 81%. Mortality rate was 94% for the oldest group (> 80 yrs) compared with 68% for the youngest group (< or = 45 yrs) (p < .01). Other independent predictors of mortality were history of diabetes mellitus, inhospital arrests, arrest time of > 5 mins, history of congestive heart failure, a noncardiac cause of arrest, and cardiopulmonary resuscitation time of > 20 mins. Of the 774 patients, 27% recovered good neurologic function. There was no statistically significant difference in neurologic recovery rates by age. Multivariate analysis showed that independent predictors of good neurologic recovery were: no history of diabetes mellitus, a cardiac cause of arrest, short arrest time, and short cardiopulmonary resuscitation time.

Conclusion: Increasing age was a factor in postresuscitation mortality, but was not an independent predictor of poor neurologic outcome.

Publication types

  • Clinical Trial
  • Clinical Trial, Phase I
  • Clinical Trial, Phase II
  • Multicenter Study
  • Randomized Controlled Trial
  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Age Factors
  • Aged
  • Aged, 80 and over
  • Cardiopulmonary Resuscitation* / mortality
  • Coma / etiology
  • Coma / mortality
  • Coma / therapy*
  • Double-Blind Method
  • Female
  • Glasgow Coma Scale
  • Heart Arrest / complications
  • Heart Arrest / mortality
  • Heart Arrest / therapy*
  • Humans
  • Lidoflazine / therapeutic use
  • Male
  • Middle Aged
  • Neurologic Examination
  • Prognosis
  • Risk Factors
  • Thiopental / therapeutic use

Substances

  • Lidoflazine
  • Thiopental