Document Detail


Resuscitation after cardiac surgery: are we ageist?
MedLine Citation:
PMID:  14768926     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND AND OBJECTIVE: To study the effect of age and other risk factors on: (a) the incidence and outcome of cardiopulmonary resuscitation and (b) any decision to institute a 'Do Not Attempt Resuscitation' order following cardiac surgery. METHODS: Prospective audit of cardiac arrest calls following 6550 consecutive open-heart surgery cases and retrospective audit of all cardiac surgical deaths not preceded by cardiac arrest calls. RESULTS: One-hundred-and-seventy-four patients (2.7%) had audited cardiac arrests of whom 70 (40%) survived to discharge. Elderly patients (> or = 70 yr old) had higher incidence of cardiac arrest (3.8% vs. 2%, P < 0.001). Survival to discharge following cardiopulmonary resuscitation was lower in the elderly patients, 33% vs. 48%, the difference approaching statistical significance (P = 0.06). Cardiopulmonary resuscitation was withheld in 46% of elderly vs. 40% of younger deaths (P = 0.40) which represented 3.1% of elderly vs. 1.2% younger patients (P < 0.001). Similar proportions of elderly (62%) and younger (67%) patients had failure of > or = 3 organ systems on institution of the 'Do Not Resuscitate' order (P = 0.70). CONCLUSION: 'Do Not Resuscitate' orders appeared twice as frequently in elderly patients (> or = 70 yr). However, the proportions of deaths without cardiopulmonary resuscitation and the organ failure scores between age groups were similar suggesting that severity of illness was more important than age in determining resuscitation status.
Authors:
J H Mackay; S J Powell; S C Charman; C Rozario
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  European journal of anaesthesiology     Volume:  21     ISSN:  0265-0215     ISO Abbreviation:  Eur J Anaesthesiol     Publication Date:  2004 Jan 
Date Detail:
Created Date:  2004-02-10     Completed Date:  2004-04-27     Revised Date:  2006-03-16    
Medline Journal Info:
Nlm Unique ID:  8411711     Medline TA:  Eur J Anaesthesiol     Country:  England    
Other Details:
Languages:  eng     Pagination:  66-71     Citation Subset:  E; IM    
Affiliation:
Papworth Hospital, Papworth Everard, Cambridge, UK. jon.mackay@papworth.nhs.uk
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Aging / physiology*
Cardiac Surgical Procedures* / mortality
Cardiopulmonary Resuscitation*
Female
Great Britain
Heart Arrest / epidemiology,  etiology
Humans
Male
Middle Aged
Multiple Organ Failure / epidemiology,  mortality
Postoperative Complications / epidemiology,  etiology
Prospective Studies
Resuscitation Orders
Retrospective Studies
Risk Factors

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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