In-hospital resuscitation among the elderly: Substantial survival to hospital discharge

The appropriateness of aggressive resuscitation in many clinical settings has been questioned. Survival rates from cardiac arrest in the elderly are generally reported as poor, and satisfactory results from resuscitation attempts prolonged beyond 15 minutes are said to be rare. It was the purpose of this study to examine success rates for resuscitation in a cohort of elderly inpatients suffering cardiac arrest. We retrospectively reviewed 213 consecutive cardiac arrests occurring during a 12-month period in a single large tertiary private hospital. Patient age, presenting rhythm, and survival to hospital discharge were recorded. Elderly was defined as age 70 years or older. Cardiac arrests in the elderly totaled 89. Average age in this cohort was 76.2 ± 4.5 years. Eighteen patients (20.2%) had return of spontaneous circulation and 8 patients survived to hospital discharge (44.4% of those with return of spontaneous circulation). No significant difference in age or presenting rhythm of survivors versus nonsurvivors could be demonstrated, although a trend to more frequent ventricular fibrillation or ventricular tachycardia was seen (P = .059, Fisher's exact). Time for resuscitation averaged 25.75 ± 9.2 minutes for survivors and 32.6 ± 22.1 minutes for nonsurvivors. Survival to hospital discharge occurs in 9% of in-hospital cardiac arrests in the elderly following average CPR times substantially in excess of 15 minutes.