Browning, J

Hacobian, Melkon, MD

Kelley, Michael B, MD

Kern, Karl B, MD

McMullan, Paul W, MD

McPherson, John A, MD

Mooney, Michael R, MD

Nanda, Sudip, MD, FACP

Nielsen, Niklas, MD, PhD

Patel, Nainesh, MD

Seder, David B, MD

Unger, Barbara T, RN

English

Lehigh Valley Health Network: LVHN Scholarly Works

Lehigh Valley Health NetworkLVHN Scholarly WorksDepartment of MedicineGeriatric Experience Following Cardiac Arrest AtSix Interventional Cardiology Centers In TheUnited States 2007-2011David B. Seder MDNainesh Patel MDLehigh Valley Health Network, nainesh_c.patel@lvhn.orgJohn A. McPherson MDPaul W. McMullan MDKarl B. Kern MDSee next page for additional authorsFollow this and additional works at: https://scholarlyworks.lvhn.org/medicinePart of the Cardiology Commons, Medical Sciences Commons, and the Statistics and ProbabilityCommonsThis Poster is brought to you for free and open access by LVHN Scholarly Works. It has been accepted for inclusion in LVHN Scholarly Works by anauthorized administrator. For more information, please contact LibraryServices@lvhn.org.Published In/Presented AtSeder, D., Patel, N., McPherson, J., McMullen, P., Kern, K., Unger, B., Browning, J., Nanda, S., Hacobian, M., Kelley, M., Nielsen, N., &Mooney, M. (2011). Geriatric experience following cardiac arrest at six interventional cardiology centers in the United States 2007-2011.Poster presentation.AuthorsDavid B. Seder MD; Nainesh Patel MD; John A. McPherson MD; Paul W. McMullan MD; Karl B. Kern MD;Barbara T. Unger RN; J Browning; Sudip Nanda MD, FACP; Melkon Hacobian MD; Michael B. Kelley MD;Niklas Nielsen MD, PhD; and Michael R. Mooney MDThis poster is available at LVHN Scholarly Works: https://scholarlyworks.lvhn.org/medicine/284Results Geriatric Experience Following Cardiac Arrest At Six Interventional Cardiology  Centers In The United States 2007-2011  DB Seder, N Patel, J McPherson, P McMullen, KB Kern, B Unger, J Browning, S Nanda, M Hacobian, MB Kelley, N Nielsen, M Mooney The International Cardiac Arrest Registry (INTCAR) – CARDIOLOGY Research Group* *Minneapolis Heart Institute, Lehigh Valley Medical Center, Vanderbilt University, Maine Medical Center, Ochsner Medical Center, and the University of Arizona Introduction Methods •It is unknown if aggressive post-resuscitation care, such as percutaneous coronary intervention (PCI) and therapeutic hypothermia (TH), benefit cardiac arrest (CA) survivors over 75 years old. [1] •Age is not considered a contraindication to PCI or TH at many centers, where anecdotal experiences suggest some elderly patients do well.  Nonetheless, some healthcare systems limit access to these treatments based on age alone.  •We evaluated the clinical experiences and outcomes of patients aged > 75 years at six regional PCI centers in the United States, and compared them to those of younger patients treated under the same protocols. •Six US Interventional Cardiology centers comprising the INTCAR-Cardiology research group retrospectively and prospectively evaluated 754 sequential cardiac arrest survivors admitted between 2007-2011.  Data were de-identified and uploaded into a secure, web-based registry (INTCAR). [2] •Demographics, hospital course, adverse events, treatments, and outcomes of 129 cardiac arrest survivors aged > 75 years were compared to 625 similar patients aged 18-75. •Data entry was locally IRB-approved at all centers, and statistical analysis was performed at Maine Medical Center.   Discussion •Cardiac arrest survivors over 75 years underwent urgent coronary angiography, PCI, and therapeutic hypothermia at rates similar to younger patients. •Older patients experienced similar adverse events as younger patients, but had more hyperglycemia and less post-cooling fever. •Older patients were more likely to have DNR orders placed and more likely to have life support withdrawn. •Short and intermediate term outcomes were worse among elderly than younger patients, yet despite a cohort that included 43.9% PEA or asystole, 26.4% patients over 75 years of age had good neurological outcome at 6 months. •Exclusion of elderly patients from aggressive post-resuscitation care does not appear warranted on the basis of age alone.   1. The Hypothermia after Cardiac Arrest Study Group. Mild therapeutic hypothermia to improve the neurologic outcome after cardiac arrest. N Engl J Med. 2002; 346:549 2. http://www.intcar.org References •INTCAR is generously supported by grants from the Stig and Ragna Gorthon Foundation, Scandinavian Society of Anaesthesiology and Intensive Care, Lund University, and Maine Medical Center •Thanks to John Dziodzio for statistical support! ADVERSE EVENTS Age 18-75 Age >75 P ANY 83.0% (519/625) 87.6% (113/129) 0.2 --Infection (any) 35.2% (220/625) 39.5% (51/129) 0.3 --Pneumonia 25.6% (160/625) 31.0% (40/129) 0.21 --Bleeding 10.1% (63/625) 10.1% (13/129) 0.999 --Seizures 26.1% (163/625) 27.9% (36/129) 0.67 --Electrolyte  disturbance 60.5% (378/625) 60.5% (78/129) 0.997 --Arrhythmia* *hemodynamically significant 37.1% (232/625) 43.4%  (56/129) 0.18 --Hyperglycemia 59.0% (369/625) 70.5%  (91/129) 0.015 --Fever 35.2% (216/614) 25.2% (32/127) 0.03 Contact: sederd@mmc.org 

Geriatric Experience Following Cardiac Arrest At Six Interventional Cardiology Centers In The United States 2007-2011

https://scholarlyworks.lvhn.org/cgi/viewcontent.cgi?article=1283&context=medicine

Geriatric Experience Following Cardiac Arrest At Six Interventional Cardiology Centers In The United States 2007-2011

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