PMID- 38370311 OWN - NLM STAT- PubMed-not-MEDLINE LR - 20240220 IS - 2666-5204 (Electronic) IS - 2666-5204 (Linking) VI - 17 DP - 2024 Mar TI - Increasing neurologically intact survival after out-of-hospital cardiac arrest among elderly: Singapore Experience. PG - 100573 LID - 10.1016/j.resplu.2024.100573 [doi] LID - 100573 AB - OBJECTIVES: With more elderly presenting with Out-of-Hospital Cardiac Arrests (OHCAs) globally, neurologically intact survival (NIS) should be the aim of resuscitation. We aimed to study the trend of OHCA amongst elderly in a large Asian registry to identify if age is independently associated with NIS and factors associated with NIS. METHODS: All adult OHCAs aged >/=18 years attended by emergency medical services (EMS) from April 2010 to December 2019 in Singapore was extracted from the Pan-Asian Resuscitation Outcomes Study (PAROS) registry. Cases pronounced dead at scene, non-EMS transported, traumatic OHCAs and OHCAs in ambulances were excluded. Patient characteristics and outcomes were compared across four age categories (18-64, 65-79, 80-89, >/=90). Multivariable logistic regression analysis determined the factors associated with NIS. RESULTS: 19,519 eligible cases were analyzed. OHCA incidence increased with age almost doubling in octogenarians (from 312/100,000 in 2011 to 652/100,000 in 2019) and tripling in those >/=90 years (from 458/100,000 in 2011 to 1271/100,000 in 2019). The proportion of patients with NIS improved over time for the 18-64, 65-79- and 80-89-years age groups, with the greatest improvement in the youngest group. NIS decreased with each increasing year of age and minute of response time. NIS increased in the arrests of presumed cardiac etiology, witnessed and bystander CPR. CONCLUSIONS: Survival with good outcomes has increased even amongst the elderly. Regardless of age, NIS is possible with good-quality CPR, highlighting its importance. End-of-life planning is a complex yet necessary decision that requires qualitative exploration with elderly, their families and care providers. CI - (c) 2024 The Author(s). FAU - Ong, Chloe Alexis AU - Ong CA AD - Lee Kong Chian School of Medicine, Nanyang Technological University of Singapore, Singapore. FAU - Nadarajan, Gayathri Devi AU - Nadarajan GD AD - Department of Emergency Medicine, Singapore General Hospital, Singapore. FAU - Fook-Chong, Stephanie AU - Fook-Chong S AD - Pre-hospital & Emergency Research Centre, Duke-NUS Medical School, Singapore. FAU - Shahidah, Nur AU - Shahidah N AD - Department of Emergency Medicine, Singapore General Hospital, Singapore. AD - Pre-hospital & Emergency Research Centre, Duke-NUS Medical School, Singapore. FAU - Arulanandam, Shalini AU - Arulanandam S AD - Military Medicine Institute, Singapore Armed Forces Medical Corps, Singapore. FAU - Ng, Yih Yng AU - Ng YY AD - Lee Kong Chian School of Medicine, Nanyang Technological University of Singapore, Singapore. AD - Digital and Smart Health Office, Ng Teng Fong Centre for Healthcare Innovation, Tan Tock Seng Hospital, Singapore. AD - Department of Preventive and Population Medicine, Tan Tock Seng Hospital, Singapore. FAU - Chia, Michael Yc AU - Chia MY AD - Emergency Department, Tan Tock Seng Hospital, Singapore. FAU - Tiah, Ling AU - Tiah L AD - Accident & Emergency, Changi General Hospital, Singapore. FAU - Mao, Desmond R AU - Mao DR AD - Department of Acute and Emergency Care, Khoo Teck Puat Hospital, Singapore. FAU - Ng, Wei Ming AU - Ng WM AD - Emergency Medicine Department, Ng Teng Fong General Hospital, Singapore. FAU - Leong, Benjamin Sh AU - Leong BS AD - Emergency Medicine Department, National University Hospital, Singapore. FAU - Doctor, Nausheen AU - Doctor N AD - Department of Emergency Medicine, Sengkang General Hospital, Singapore. FAU - Ong, Marcus Eh AU - Ong ME AD - Department of Emergency Medicine, Singapore General Hospital, Singapore. AD - Health Services & Systems Research, Duke-NUS Medical School, Singapore. FAU - Siddiqui, Fahad J AU - Siddiqui FJ AD - Pre-hospital & Emergency Research Centre, Duke-NUS Medical School, Singapore. LA - eng PT - Journal Article DEP - 20240209 PL - Netherlands TA - Resusc Plus JT - Resuscitation plus JID - 101774410 PMC - PMC10869923 OTO - NOTNLM OT - Cardiopulmonary resuscitation OT - Elderly OT - Epidemiology OT - Out-of-hospital cardiac arrest OT - Quality of life COIS- The authors declare the following financial interests/personal relationships which may be considered as potential competing interests: MEH Ong reports grants from the Laerdal Foundation, Laerdal Medical, and Ramsey Social Justice Foundation for funding of the Pan-Asian Resuscitation Outcomes Study; an advisory relationship with Global Healthcare SG, a commercial entity that manufactures cooling devices. MEH Ong has a licensing agreement with ZOLL Medical Corporation and patent filed (Application no: 13/047,348) for a "Method of predicting acute cardiopulmonary events and survivability of a patient." He is also the co-founder and scientific advisor of TIIM Healthcare, a commercial entity which develops real-time prediction and risk stratification solutions for triage. All other authors have no conflict of interest to disclose. EDAT- 2024/02/19 06:43 MHDA- 2024/02/19 06:44 PMCR- 2024/02/09 CRDT- 2024/02/19 04:09 PHST- 2023/11/30 00:00 [received] PHST- 2024/01/10 00:00 [revised] PHST- 2024/01/23 00:00 [accepted] PHST- 2024/02/19 06:44 [medline] PHST- 2024/02/19 06:43 [pubmed] PHST- 2024/02/19 04:09 [entrez] PHST- 2024/02/09 00:00 [pmc-release] AID - S2666-5204(24)00024-9 [pii] AID - 100573 [pii] AID - 10.1016/j.resplu.2024.100573 [doi] PST - epublish SO - Resusc Plus. 2024 Feb 9;17:100573. doi: 10.1016/j.resplu.2024.100573. eCollection 2024 Mar.