Changes in the neurological status from 30 to 90 days post-cardiac arrest by age: A nationwide retrospective observational study

Introduction: Few studies have investigated the changes in the neurological status after 30 days post-arrest in out-of-hospital cardiac arrest (OHCA) patients according to the patient age. The aim of this study was to investigate the differences in the mid-term (from 30 days to 90 days) neurological...

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Main Authors: Hiromi Miyoshi, Mitsuaki Nishikimi, Kazuya Kikutani, Shinichiro Ohshimo, Nobuaki Shime
Format: Article
Language:English
Published: Elsevier 2025-03-01
Series:Resuscitation Plus
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Online Access:http://www.sciencedirect.com/science/article/pii/S2666520425000542
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author Hiromi Miyoshi
Mitsuaki Nishikimi
Kazuya Kikutani
Shinichiro Ohshimo
Nobuaki Shime
author_facet Hiromi Miyoshi
Mitsuaki Nishikimi
Kazuya Kikutani
Shinichiro Ohshimo
Nobuaki Shime
author_sort Hiromi Miyoshi
collection DOAJ
description Introduction: Few studies have investigated the changes in the neurological status after 30 days post-arrest in out-of-hospital cardiac arrest (OHCA) patients according to the patient age. The aim of this study was to investigate the differences in the mid-term (from 30 days to 90 days) neurological changes after CA according to the age group. Methods: We retrospectively analysed the data of all OHCA patients aged ≥1 year who showed return of spontaneous circulation and survived until 30 days after CA. We compared the proportions of patients who showed neurological deterioration from 30 to 90 days post-CA by age group (1–17, 18–39, 40–64, 65–79, ≥80 years). The neurological outcome was assessed by the Cerebral Performance Category (CPC) or Pediatric Cerebral Performance Category (PCPC) scale. Results: Of the 68,110 registered patients, we analysed the data of a total of 2,663 patients. The neurological deterioration rate and improvement rate from 30 to 90 days after CA in each age group were as follows: 1–17 years: 11.6% (8/69)/7.2% (5/69); 18–39 years: 8.3% (15/181)/6.1% (11/181); 40–64 years: 7.3% (72/982)/7.0% (69/982); 65–79 years: 13.5% (130/965)/8.1% (78/965); and ≥ 80 years: 24.2% (113/466)/4.9% (23/466). Multivariable logistic regression analysis showed a higher likelihood of mid-term neurological deterioration in patients aged ≥ 80 years than in those aged 1–17 years. Conclusions: Most OHCA patients, irrespective of age, showed no change of the neurological status from 30 to 90 days after OHCA. However, a relatively large percentage of patients aged ≥80 years old showed significant neurological deterioration after 30 days post-OHCA.
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spelling doaj-art-ba511e94b17b4b2fb0273cf12f3ce6892025-08-20T02:07:19ZengElsevierResuscitation Plus2666-52042025-03-012210091710.1016/j.resplu.2025.100917Changes in the neurological status from 30 to 90 days post-cardiac arrest by age: A nationwide retrospective observational studyHiromi Miyoshi0Mitsuaki Nishikimi1Kazuya Kikutani2Shinichiro Ohshimo3Nobuaki Shime4Department of Emergency and Critical Care Medicine, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, JapanCorresponding author at: 1-2-3 Kasumi, Minami-ku, Hiroshima 734-8551, Japan.; Department of Emergency and Critical Care Medicine, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, JapanDepartment of Emergency and Critical Care Medicine, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, JapanDepartment of Emergency and Critical Care Medicine, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, JapanDepartment of Emergency and Critical Care Medicine, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, JapanIntroduction: Few studies have investigated the changes in the neurological status after 30 days post-arrest in out-of-hospital cardiac arrest (OHCA) patients according to the patient age. The aim of this study was to investigate the differences in the mid-term (from 30 days to 90 days) neurological changes after CA according to the age group. Methods: We retrospectively analysed the data of all OHCA patients aged ≥1 year who showed return of spontaneous circulation and survived until 30 days after CA. We compared the proportions of patients who showed neurological deterioration from 30 to 90 days post-CA by age group (1–17, 18–39, 40–64, 65–79, ≥80 years). The neurological outcome was assessed by the Cerebral Performance Category (CPC) or Pediatric Cerebral Performance Category (PCPC) scale. Results: Of the 68,110 registered patients, we analysed the data of a total of 2,663 patients. The neurological deterioration rate and improvement rate from 30 to 90 days after CA in each age group were as follows: 1–17 years: 11.6% (8/69)/7.2% (5/69); 18–39 years: 8.3% (15/181)/6.1% (11/181); 40–64 years: 7.3% (72/982)/7.0% (69/982); 65–79 years: 13.5% (130/965)/8.1% (78/965); and ≥ 80 years: 24.2% (113/466)/4.9% (23/466). Multivariable logistic regression analysis showed a higher likelihood of mid-term neurological deterioration in patients aged ≥ 80 years than in those aged 1–17 years. Conclusions: Most OHCA patients, irrespective of age, showed no change of the neurological status from 30 to 90 days after OHCA. However, a relatively large percentage of patients aged ≥80 years old showed significant neurological deterioration after 30 days post-OHCA.http://www.sciencedirect.com/science/article/pii/S2666520425000542Post-cardiac arrest syndromeNeurological prognosisMid-term neurological changesAgeOut-of-hospital cardiac arrest
spellingShingle Hiromi Miyoshi
Mitsuaki Nishikimi
Kazuya Kikutani
Shinichiro Ohshimo
Nobuaki Shime
Changes in the neurological status from 30 to 90 days post-cardiac arrest by age: A nationwide retrospective observational study
Resuscitation Plus
Post-cardiac arrest syndrome
Neurological prognosis
Mid-term neurological changes
Age
Out-of-hospital cardiac arrest
title Changes in the neurological status from 30 to 90 days post-cardiac arrest by age: A nationwide retrospective observational study
title_full Changes in the neurological status from 30 to 90 days post-cardiac arrest by age: A nationwide retrospective observational study
title_fullStr Changes in the neurological status from 30 to 90 days post-cardiac arrest by age: A nationwide retrospective observational study
title_full_unstemmed Changes in the neurological status from 30 to 90 days post-cardiac arrest by age: A nationwide retrospective observational study
title_short Changes in the neurological status from 30 to 90 days post-cardiac arrest by age: A nationwide retrospective observational study
title_sort changes in the neurological status from 30 to 90 days post cardiac arrest by age a nationwide retrospective observational study
topic Post-cardiac arrest syndrome
Neurological prognosis
Mid-term neurological changes
Age
Out-of-hospital cardiac arrest
url http://www.sciencedirect.com/science/article/pii/S2666520425000542
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AT kazuyakikutani changesintheneurologicalstatusfrom30to90dayspostcardiacarrestbyageanationwideretrospectiveobservationalstudy
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