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Published on: August 30, 2011
Resuscitation after cardiac surgery: are we ageist?
J H Mackay1, S J Powell, S C Charman
1Papworth Hospital, Papworth Everard, Cambridge, UK. jon.mackay@papworth.nhs.uk
European Journal of Anaesthesiology
|February 11, 2004
Summary
Elderly patients undergoing cardiac surgery experienced more cardiac arrests, with lower survival rates after cardiopulmonary resuscitation. Age was less critical than illness severity in
Area of Science:
- Cardiovascular Surgery
- Critical Care Medicine
- Geriatric Medicine
Background:
- Cardiac surgery patients face risks of cardiac arrest and the need for resuscitation.
- Age and other factors influence resuscitation outcomes and 'Do Not Attempt Resuscitation' decisions.
Purpose of the Study:
- To investigate the impact of age on cardiac arrest incidence and outcomes.
- To analyze the factors influencing 'Do Not Attempt Resuscitation' orders post-cardiac surgery.
Main Methods:
- A prospective audit of 6550 open-heart surgery cases for cardiac arrest calls.
- A retrospective audit of cardiac surgical deaths without preceding arrest calls.
Main Results:
- Elderly patients (>= 70 years) had a higher incidence of cardiac arrest (3.8% vs. 2%) and lower survival post-resuscitation (33% vs. 48%).
- 'Do Not Attempt Resuscitation' orders were more frequent in elderly patients (twice as common).
- Organ system failure rates were similar between age groups when resuscitation status was determined.
Conclusions:
- While elderly patients had more cardiac arrests and 'Do Not Attempt Resuscitation' orders, illness severity, not just age, determined resuscitation status.
- The study highlights the importance of comprehensive patient assessment beyond age for resuscitation decisions.
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