Abstract Background Despite advances in the management, the prognosis of patients with out-of-hospital cardiac arrest (OHCA) remains poor. Although chronological age is a predictor of outcomes after OHCA, recent data are limited. Purpose To describe contemporary trends and patterns of prehospital treatment and outcomes of septuagenarians, octogenarians, and nonagenarians with OHCA. Methods Using a Japanese nationwide registry database from 2015 to 2022, a cohort of 1,003,873 OHCA patients with and without a bystander witness aged from 20 to 99 years were analyzed. Patients were divided into four age categories: 20-69 years, 70s (70-79 years), 80s (80-89 years), and 90s (90-99 years). The primary endpoint was overall and neurologically favorable survival at one month. Temporal trends of prehospital treatments and outcomes were also evaluated. Results Of the witnessed patients, 23.9%, 32.8%, and 16.1% were in their 70s, 80s, and 90s, respectively. Although the rates of prehospital treatment such as advanced airway management and intravenous epinephrine decreased as age increased, these therapies were performed in around 30% of nonagenarians in a contemporary setting (Figure 1). The total number of OHCA patients has been increasing, with an increase in nonagenarians and a plateau in septuagenarians and octogenarians, while decreasing in the age 20-69 years. The older age was associated with lower overall and neurologically favorable survival rates, which did not meaningfully change from 2015 to 2022 among the four age groups. Bystander cardiopulmonary resuscitation was associated with better survival, while prehospital advanced airway management and intravenous epinephrine were not (Figure 2). Conclusions Our nationwide registry study demonstrated that among patients with OHCA, octogenarians were the leading patient group in proportion, and the number of nonagenarians has been increasing. Despite the increasingly frequent prehospital treatment, no relevant improvements in outcomes of OHCA were observed during the study period.Temporal trends of OHCA in Japan Prehospital treatments and outcomes
Saito et al. (Sat,) studied this question.