Age-Related Comorbidities and Outcomes in Cardiac Arrest Patients: A Focus on Targeted Temperature Management
Ömer Zühtü Yöndem, Orhun Demir, Barış Ecevit Yüksel
Lokman Hekim Üniversitesi
Giriş: Targeted temperature management (TTM) is recommended for adults after cardiac arrest who remains unresponsive after restoration of spontaneous circulation(1). The survival, physical, emotional and neurological outcome of older patients was worse compared with younger adults after resuscitation(2,3). We aimed to investigate the impact of age on patients receiving TTM after cardiac arrest.
Gereç ve Yöntem: Between 2015 and 2023 among 2054 cardiac arrest patients 262 intensive care patients were included in this retrospective study (Figure 1). Exclusion criteria: patients expired in emergency department, are under 18 years old, didn’t receive TTM. The patients were enrolled into 2 groups; Group1: aged under 70, Group 2: aged over 70. Groups were compared in terms of demographic and clinical data (Table 1).
Bulgular: The overall mortality rate was significantly high, with 82.1% of the patients. Group 2 exhibited significantly higher mortality (96.3%,) compared to Group 1 (72.1%) (p < 0.001). The prevalence of hypertension was high across the cohort, affecting 62.8% of patients. APACHE Scores and comorbidities: Hypertension, hyperlipidemia coronary artery disease chronic obstructive pulmonary disease, diabetes mellitus were significantly more common Group 2, compared to Group 1. (p < 0.001).
Tartışma ve Sonuç: DiscussionIn a recent study no association was found between TTM and improved mortality in older population4. Additionally, as patients aged, they were less likely to receive TTM regardless of their first rhythm(4). Grimaldi et al reported increasing age decreases favorable neurological outcome in resuscitated patients(5). In concordance with the literature our findings suggest that advanced age is strongly associated with worse outcomes and older patients had a higher burden of cardiovascular and metabolic comorbidities, which may have contributed to the observed increased mortality in this group.Conclusion:TTM seems less beneficial in elderly when compared young adult resuscitated patients. Further studies should focus on personalized TTM strategy in the elderly.
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