SHOULD THE ELDERLY BE RESUSCITATED - EXPERIENCE IN A DISTRICT GENERAL-HOSPITAL

Background: This study evaluates the success rate of cardiopulmonary resuscitation and aims to identify the characteristics of patients and the cardiac arrest setting that may influence outcome. Methods: Between 1 January 1990 and 31 December 1990, 148 patients underwent cardiopulmonary resuscitation in a district general hospital in Ashford, Kent, United Kingdom. The case notes and resuscitation notes for these patients were reviewed retrospectively. Follow-up of patients that survived to be discharged was obtained at routine clinic visits or by telephone interview with the patients or relatives. Results: Resuscitation was initially successful in 47 patients (32%) as judged by return of vital signs, but only 14 (9%) survived to hospital discharge. Advanced age did not adversely affect long-term survival after cardiopulmonary resuscitation. Of the 14 patients who survived to be discharged, 10 were more than 70 years of age and five were more than 80 years of age. Underlying disease and presenting arrhythmia were both major determinants of survival. Multiple trauma and terminal or incurable disease were associated with a poor prognosis. In addition, asystole and electromechanical dissociation were associated with a poor outcome. Conclusions: Advanced age is not an important determinant of outcome of attempted cardiopulmonary resuscitation. The decision regarding whether to subject a patient to resuscitation should not be based on age and should take into account the underlying disease, its associated prognosis, and the patient's level of dependence.