Epidemiology and outcome of sudden cardiac arrest in elderly Nigerians: a prospective multicentre observational survey

Objective Limited information is available on sudden cardiac arrest (SCA) care in the elderly population in sub-Saharan Africa, despite the growing incidence of risk factors such as cardiovascular diseases. The aim of this study was to describe the epidemiology and assess the outcomes of out-of-hospital and in-hospital SCA among the elderly population in Nigeria. Design Prospective, multicentre observational survey on epidemiology and outcome of SCA arrest in Nigerian adults over a 20-month period. Setting Six purposefully selected teaching hospitals in the six geopolitical zones of Nigeria. Participants Patients aged 65 years and above who experienced either out-of-hospital cardiac arrest (OHCA) brought to the selected hospital or in-hospital cardiac arrest (IHCA). Data were analysed using IBM-SPSS V.25.0 (SPSS, Chicago, Illinois, USA). Descriptive statistics were used to summarise the data. Outcome measures Main outcome measures were return of spontaneous circulation (ROSC) from initial arrest, survival to hospital admission and survival to hospital discharge. Results A total of 1069 (27.3%) out of the 3909 SCA data collected were elderly (aged ≥65 years). Of this, 91.0% were IHCA and 9.0% were OHCA. The age ranged from 65 years to 105 years, with a median of 75 (IQR 70–81) years for IHCA, and 65 years to 115 years, with a median of 72 (IQR 68–78) years for OHCA. There was a male preponderance in both cohorts, but the difference was not statistically significant (p=0.971). Arrests were witnessed in 97.2% of IHCA and 94.8% of OHCA events. Cardiopulmonary resuscitation (CPR) yielded ROSC of 0.3% in IHCA and 3.1% in OHCA, and an overall hospital discharge survival of 0.1% and 2.1%, respectively. Conclusion The overall survival in both IHCA and OHCA was poor in elderly Nigerians, with a very low rate of bystander CPR in both OHCA and IHCA, despite the high rate of witness presence.