Skip to main content

Abstract

As a result of the combined effect of decreasing fertility and increasing life expectancy, the world’s population is ageing rapidly, and the process has accelerated in the last three decades. For the first time since the beginning of recorded history, elderly people are outnumbering young children [1]. By 2050, the numbers of people aged 60 years and over will have more than doubled, increasing from 901 million in 2015 to 2.1 billion [2]. The numbers of people aged 80 years and over will more than triple, increasing from 125 million in 2015 to 464 million in 2050. Although Europe has currently the highest percentage (24%) of people older than 60 years of age, the fastest growth in this age group is occurring in Asia, Africa and Latin America, so that relevant ageing will affect the whole world population in the next 30 years [2].

Consistently with a progressive ageing of the world population, the number of cardiac arrests in older people is expected to increase in the next decades. This will raise a series of social, ethical, and economic concerns. Given the inherent frailty of aged patients and the high rates of death or persistent disability associated with cardiac arrest, resuscitation of many aged patients may be seen as inappropriate. To assist with decisions on providing resuscitation in these patients, healthcare providers will need to predict as accurately as possible the likelihood of survival with an acceptable quality of life.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 119.00
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 159.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  1. US Department of Health and Human Services – National Institute on Aging (2015) Global health and aging. https://www.nia.nih.gov/research/publication/global-health-and-aging/assessing-costs-aging-and-health-care. Accessed October 2015

    Google Scholar 

  2. United Nations – Department of Economic and Social Affairs – Population Division (2015) World Population Prospects – The 2015 Revision. Working Paper No ESA/P/WP241. http://esa.un.org/unpd/wpp/. Accessed October 2015

    Google Scholar 

  3. Tung P, Albert CM (2013) Causes and prevention of sudden cardiac death in the elderly. Nat Rev Cardiol 10:135–142

    Article  PubMed  Google Scholar 

  4. Sandroni C, Nolan J, Cavallaro F, Antonelli M (2007) In-hospital cardiac arrest: incidence, prognosis and possible measures to improve survival. Intensive Care Med 33:237–245

    Article  PubMed  Google Scholar 

  5. Organisation for Economic Co-operation and Development (2012) Ageing and Employment Policies – Statistics on average effective age of retirement. http://www.oecd.org/els/emp/ageingandemploymentpolicies-statisticsonaverageeffectiveageofretirement.htm. Accessed October 2015

    Google Scholar 

  6. McNally B, Robb R, Mehta M et al (2011) Out-of-hospital cardiac arrest surveillance – Cardiac Arrest Registry to Enhance Survival (CARES), United States, October 1, 2005 – December 31, 2010. MMWR Surveill Summ 60:1–19

    PubMed  Google Scholar 

  7. Deasy C, Bray JE, Smith K, Harriss LR, Bernard SA, Cameron P (2011) Out-of-hospital cardiac arrests in the older age groups in Melbourne. Australia Resuscitation 82:398–403

    Article  CAS  PubMed  Google Scholar 

  8. Winther-Jensen M, Pellis T, Kuiper M et al (2015) Mortality and neurological outcome in the elderly after target temperature management for out-of-hospital cardiac arrest. Resuscitation 91:92–98

    Article  PubMed  Google Scholar 

  9. Ahn KO, Shin SD, Suh GJ et al (2010) Epidemiology and outcomes from non-traumatic out-of-hospital cardiac arrest in Korea: A nationwide observational study. Resuscitation 81:974–981

    Article  PubMed  Google Scholar 

  10. Chien DK, Chang WH, Tsai SH, Chang KS, Chen CC, Su YJ (2008) Outcome of non-traumatic out-of-hospital cardiac arrest in the elderly. International Journal of Gerontology 2:60–66

    Article  Google Scholar 

  11. Peberdy MA, Kaye W, Ornato JP et al (2003) Cardiopulmonary resuscitation of adults in the hospital: a report of 14720 cardiac arrests from the National Registry of Cardiopulmonary Resuscitation. Resuscitation 58:297–308

    Article  PubMed  Google Scholar 

  12. Churpek MM, Yuen TC, Winslow C, Hall J, Edelson DP (2014) Differences in vital signs between elderly and nonelderly patients prior to ward cardiac arrest. Crit Care Med 43:816–822

    Article  Google Scholar 

  13. Chugh SS, Jui J, Gunson K, Stecker EC et al (2004) Current burden of sudden cardiac death: multiple source surveillance versus retrospective death certificate-based review in a large U.S. community. J Am Coll Cardiol 44:1268–1275

    Article  PubMed  Google Scholar 

  14. George J, Rapsomaniki E, Pujades-Rodriguez M et al (2015) How does cardiovascular disease first present in women and men? Incidence of 12 cardiovascular diseases in a contemporary cohort of 1,937,360 people. Circulation 132:1320–1328

    Article  PubMed  PubMed Central  Google Scholar 

  15. Van Hoeyweghen RJ, Bossaert LL, Mullie A et al (1992) Survival after out-of-hospital cardiac arrest in elderly patients. Belgian Cerebral Resuscitation Study Group. Ann Emerg Med 21:1179–1184

    Article  PubMed  Google Scholar 

  16. Teodorescu C, Reinier K, Dervan C et al (2010) Factors associated with pulseless electric activity versus ventricular fibrillation: the Oregon sudden unexpected death study. Circulation 122:2116–2122

    Article  PubMed  Google Scholar 

  17. Chan PS, Nallamothu BK, Krumholz HM et al (2013) Long-term outcomes in elderly survivors of in-hospital cardiac arrest. N Engl J Med 368:1019–1026

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  18. Van De Glind EM, Van Munster BC, Van De Wetering FT, Van Delden JJ, Scholten RJ, Hooft L (2013) Pre-arrest predictors of survival after resuscitation from out-of-hospital cardiac arrest in the elderly a systematic review. BMC Geriatrics 13:68

    Article  PubMed  PubMed Central  Google Scholar 

  19. Hagiwara S, Kaneko M, Murata M et al (2015) Study on the effectiveness of cardiopulmonary resuscitation in elderly patients presenting with cardiopulmonary arrest on arrival. Intern Med 54:1859–1863

    Article  PubMed  Google Scholar 

  20. Kim C, Becker L, Eisenberg MS (2000) Out-of-hospital cardiac arrest in octogenarians and nonagenarians. Arch Intern Med 160:3439–3443

    Article  CAS  PubMed  Google Scholar 

  21. Pleskot M, Hazukova R, Stritecka H, Cermakova E (2011) Five-year survival of patients after out-of-hospital cardiac arrest depending on age. Arch Gerontol Geriatr 53:e88–e92

    Article  PubMed  Google Scholar 

  22. Schwenzer KJ, Smith WT, Durbin CG Jr (1993) Selective application of cardiopulmonary resuscitation improves survival rates. Anesth Analg 76:478–484

    Article  CAS  PubMed  Google Scholar 

  23. Seder DB, Patel N, McPherson J et al (2014) Geriatric experience following cardiac arrest at Six Interventional Cardiology Centers in the United States 2006–2011: Interplay of age, do-not-resuscitate order, and outcomes. Crit Care Med 42:289–295

    Article  PubMed  Google Scholar 

  24. Snyder JE, Loschner AL, Kepley HO (2010) The effect of patient age on perceived resuscitation outcomes by practitioners. N C Med J 71:199–205

    PubMed  Google Scholar 

  25. Swor RA, Jackson RE, Tintinalli JE, Pirrallo RG (2000) Does advanced age matter in outcomes after out-of-hospital cardiac arrest in community-dwelling adults? Acad Emerg Med 7:762–768

    Article  CAS  PubMed  Google Scholar 

  26. Nolan JP, Soar J, Smith GB et al (2014) Incidence and outcome of in-hospital cardiac arrest in the United Kingdom National Cardiac Arrest Audit. Resuscitation 85:987–992

    Article  PubMed  Google Scholar 

  27. Ehlenbach WJ, Barnato AE, Curtis JR et al (2009) Epidemiologic study of in-hospital cardiopulmonary resuscitation in the elderly. N Engl J Med 361:22–31

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  28. Bunch TJ, White RD, Khan AH, Packer DL (2004) Impact of age on long-term survival and quality of life following out-of-hospital cardiac arrest. Crit Care Med 32:963–967

    Article  PubMed  Google Scholar 

  29. Cooper S, Cade J (1997) Predicting survival, in-hospital cardiac arrests: resuscitation survival variables and training effectiveness. Resuscitation 35:17–22

    Article  CAS  PubMed  Google Scholar 

  30. Di Bari M, Chiarlone M, Fumagalli S et al (2000) Cardiopulmonary resuscitation of older, inhospital patients: immediate efficacy and long-term outcome. Crit Care Med 28:2320–2325

    Article  PubMed  Google Scholar 

  31. Wuerz RC, Holliman CJ, Meador SA, Swope GE, Balogh R (1995) Effect of age on prehospital cardiac resuscitation outcome. Am J Emerg Med 13:389–391

    Article  CAS  PubMed  Google Scholar 

  32. Grimaldi D, Dumas F, Perier MC et al (2014) Short- and long-term outcome in elderly patients after out-of-hospital cardiac arrest: a cohort study. Crit Care Med 42:2350–2357

    Article  PubMed  Google Scholar 

  33. Boyd K, Teres D, Rapoport J, Lemeshow S (1996) The relationship between age and the use of DNR orders in critical care patients. Evidence for age discrimination. Arch Intern Med 156:1821–1826

    Article  CAS  PubMed  Google Scholar 

  34. Kitamura T, Morita S, Kiyohara K et al (2014) Trends in survival among elderly patients with out-of-hospital cardiac arrest: A prospective, population-based observation from 1999 to 2011 in Osaka. Resuscitation 85:1432–1438

    Article  PubMed  Google Scholar 

  35. Sandroni C, D'Arrigo S, Antonelli M (2015) Rapid response systems: are they really effective? Crit Care 19:104

    Article  PubMed  PubMed Central  Google Scholar 

  36. Lamantia MA, Stewart PW, Platts-Mills TF et al (2013) Predictive value of initial triage vital signs for critically ill older adults. West J Emerg Med 14:453–460

    Article  PubMed  PubMed Central  Google Scholar 

  37. Nasa P, Juneja D, Singh O (2012) Severe sepsis and septic shock in the elderly: An overview. World J Crit Care Med 1:23–30

    Article  PubMed  PubMed Central  Google Scholar 

  38. Morrison LJ, Verbeek PR, Zhan C, Kiss A, Allan KS (2009) Validation of a universal prehospital termination of resuscitation clinical prediction rule for advanced and basic life support providers. Resuscitation 80:324–328

    Article  PubMed  Google Scholar 

  39. Morrison LJ, Visentin LM, Kiss A et al (2006) Validation of a rule for termination of resuscitation in out-of-hospital cardiac arrest. N Engl J Med 355:478–487

    Article  CAS  PubMed  Google Scholar 

  40. Richman PB, Vadeboncoeur TF, Chikani V, Clark L, Bobrow BJ (2008) Independent evaluation of an out-of-hospital termination of resuscitation (TOR) clinical decision rule. Acad Emerg Med 15:517–521

    Article  PubMed  Google Scholar 

  41. Fabbri A, Marchesini G, Spada M, Iervese T, Dente M, Galvani M (2006) Monitoring intervention programmes for out-of-hospital cardiac arrest in a mixed urban and rural setting. Resuscitation 71:180–187

    Article  PubMed  Google Scholar 

  42. Sandroni C, Dell'Anna AM (2014) Cardiopulmonary resuscitation above 75 years: is it worthwhile? Crit Care Med 42:2446–2447

    Article  PubMed  Google Scholar 

  43. Geocadin RG, Buitrago MM, Torbey MT, Chandra-Strobos N, Williams MA, Kaplan PW (2006) Neurologic prognosis and withdrawal of life support after resuscitation from cardiac arrest. Neurology 67:105–108

    Article  CAS  PubMed  Google Scholar 

  44. Dragancea I, Rundgren M, Englund E, Friberg H, Cronberg T (2013) The influence of induced hypothermia and delayed prognostication on the mode of death after cardiac arrest. Resuscitation 84:337–342

    Article  PubMed  Google Scholar 

  45. Sandroni C, Cariou A, Cavallaro F et al (2014) Prognostication in comatose survivors of cardiac arrest: An advisory statement from the European Resuscitation Council and the European Society of Intensive Care Medicine. Resuscitation 85:1779–1789

    Article  PubMed  Google Scholar 

  46. Sandroni C, Cavallaro F, Callaway CW et al (2013) Predictors of poor neurological outcome in adult comatose survivors of cardiac arrest: a systematic review and meta-analysis. Part 2: Patients treated with therapeutic hypothermia. Resuscitation 84:1324–1338

    Article  PubMed  Google Scholar 

  47. Sandroni C, Cavallaro F, Callaway CW et al (2013) Predictors of poor neurological outcome in adult comatose survivors of cardiac arrest: a systematic review and meta-analysis. Part 1: patients not treated with therapeutic hypothermia. Resuscitation 84:1310–1323

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to C. Sandroni .

Editor information

Editors and Affiliations

Rights and permissions

Reprints and permissions

Copyright information

© 2016 Springer International Publishing Switzerland

About this chapter

Cite this chapter

Sandroni, C., D’Arrigo, S., Antonelli, M. (2016). Cardiac Arrest in the Elderly: Epidemiology and Outcome. In: Vincent, JL. (eds) Annual Update in Intensive Care and Emergency Medicine 2016. Annual Update in Intensive Care and Emergency Medicine. Springer, Cham. https://doi.org/10.1007/978-3-319-27349-5_18

Download citation

  • DOI: https://doi.org/10.1007/978-3-319-27349-5_18

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-27348-8

  • Online ISBN: 978-3-319-27349-5

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics