Abstract 146: Advanced Age and Neurological Recovery in Elderly Patients With Out-of-Hospital Cardiac Arrest Treated With Targeted Temperature Management: A Nationwide Population-Based Registry Study

Abstract

Objectives: The chance of neurological recovery after out-of-hospital cardiac arrest (OHCA) can be influenced by advanced age, however further recent evidence will be need in elderly population. The purpose of this study is to evaluate the impact of advanced age on the neurological recovery in elderly OHCA survivors treated with targeted temperature management (TTM). Methods: 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 enrolled. The elderly patients were divided into four groups (65-69 years, 70-74 years, 75-79 years, and ≥ 80 years). The primary outcome was good neurological outcome, defined as Cerebral Performance Categories (CPC) of 1 or 2 at hospital discharge. Results: Among 23,336 OHCA patients who admitted to the hospital, 3,398 patients treated with TTM. Excluding 2,033 non-elderly patients, 1,365 patients were analyzed. In four elderly group, the rate of good neurological outcomes were decreased by advanced age (24.2%, 16.1%, 11.4%, and 5.9%). This was also observed after subgroup analysis based on the initial shockable (40.6%, 31.5%, 28.6%, and 14.9%) and non-shockable rhythm (10.6%, 7.2%, 4.1%, and 3.4%). Multivariate analysis showed the adjusted odds ratio (aOR) for good neurological outcome decreased as advanced age (65-69 years: reference, 70-74 years: aOR 0.70, 75-79 years: aOR 0.49, and ≥ 80: aOR 0.25). The optimal age cutoffs for good outcome in elderly OHCA survivors with shockable and non-shockable rhythm were 77 years and 72 years respectively. Conclusions: The neurologic recovery rate in OHCA survivors treated with TTM was gradually decreased with advanced age. However even with ≥ 80 years with shockable rhythm, had a good neurologic outcome of 14.9%, which is higher than 65-69 years of 10.6% in non-shockable rhythm.