Abstract

Background: This study determined the factors that affect survival to discharge and 1-year survival among older adults with in-hospital cardiac arrest who underwent cardiopulmonary resuscitation (CPR).

Methods: A retrospective longitudinal cohort study based on data from Taiwan's National Health Insurance Research Database from January 1, 2000, to December 31, 2012. A population-based study including 6034 eligible participants aged ≥ 65 years who underwent a first CPR event. Demographic factors, comorbidities, main admission diagnoses, CPR process, and tube dependency were assessed. Logistic regression analysiswas used to estimate the odds ratios (ORs) and 95% confidence intervals (CIs) for the probability of survival to discharge and the association between risk factors and 1-year survival.

Results: In the survival-to-discharge model, either univariate or multivariate analysis, patients with age ≥ 85 years, with a main diagnosis of infection or malignancy at admission, with nonventricular fatal arrhythmia or longer duration of cardiac massage, and requiring a nasogastric tube were less likely to be successfully resuscitated. The following factors decreased 1-year survival among surviving older adults with noncritical discharge: older age, male sex, high Charlson-Deyo Comorbidity Index (CCI) scores, and long-term tube dependency after CPR, with the need for three tubes being the strongest risk factor (OR: 6.818, 95% CI: 4.068-11.427, p < 0.001).

Conclusions and Implications: CPR process was the most important factor of survival to discharge among older adults with in-hospital cardiac arrest, and long-term multiple-tube dependency, which implies functional deficits, was the strongest factor affecting 1-year survival.