Impact of age on the prognosis of patients with ventricular tachyarrhythmias and aborted cardiac arrest Auswirkungen des Alters auf die Prognose von Patienten mit ventrikulären Tachyarrhythmien und überlebtem Herzstillstand

Media type: E-Article
Title: Impact of age on the prognosis of patients with ventricular tachyarrhythmias and aborted cardiac arrest Auswirkungen des Alters auf die Prognose von Patienten mit ventrikulären Tachyarrhythmien und überlebtem Herzstillstand
Contributor: Weidner, Kathrin; Schupp, Tobias; Rusnak, Jonas; El-Battrawy, Ibrahim; Ansari, Uzair; Hoppner, Jorge; Mueller, Julian; Kittel, Maximilian; Taton, Gabriel; Reiser, Linda; Bollow, Armin; Reichelt, Thomas; Ellguth, Dominik; Engelke, Niko; Große Meininghaus, Dirk; Akin, Muharrem; Bertsch, Thomas; Akin, Ibrahim; Behnes, Michael
imprint: Springer Science and Business Media LLC, 2023
Published in: Zeitschrift für Gerontologie und Geriatrie
Language: English
DOI: 10.1007/s00391-022-02131-6
ISSN: 0948-6704; 1435-1269
Keywords: Geriatrics and Gerontology ; Gerontology ; Health (social science) ; Issues, ethics and legal aspects
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Description: <jats:title>Abstract</jats:title><jats:sec> <jats:title>Background</jats:title> <jats:p>This study evaluated the prognostic impact of age on patients presenting with ventricular tachyarrhythmias (VTA) and aborted cardiac arrest.</jats:p> </jats:sec><jats:sec> <jats:title>Material and methods</jats:title> <jats:p>The present registry-based, monocentric cohort study included all consecutive patients presenting at the University Medical Center Mannheim (UMM) between 2002 and 2016 with ventricular tachycardia (VT), ventricular fibrillation (VF) and aborted cardiac arrest. Middle-aged (40–60 years old) were compared to older patients (> 60 years old). Furthermore, age was analyzed as a continuous variable. The primary endpoint was all-cause mortality at 2.5 years. The secondary endpoints were cardiac death at 24 h, all-cause mortality at index hospitalization, all-cause mortality after index hospitalization and the composite endpoint at 2.5 years of cardiac death at 24 h, recurrent VTA, and appropriate implantable cardioverter defibrillator (ICD) treatment.</jats:p> </jats:sec><jats:sec> <jats:title>Results</jats:title> <jats:p>A total of 2259 consecutive patients were included (28% middle-aged, 72% older). Older patients were more often associated with all-cause mortality at 2.5 years (27% vs. 50%; hazard ratio, HR = 2.137; 95% confidence interval, CI 1.809–2.523, <jats:italic>p</jats:italic> = 0.001) and the secondary endpoints. Even patient age as a continuous variable was independently associated with mortality at 2.5 years in all types of VTA. Adverse prognosis in older patients was demonstrated by multivariate Cox regression analyses and propensity score matching. Chronic kidney disease (CKD), systolic left ventricular dysfunction (LVEF) < 35%, cardiopulmonary resuscitation (CPR) and cardiogenic shock worsened the prognosis for both age groups, whereas acute myocardial infarction (STEMI/NSTEMI) and the presence of an ICD improved prognosis<jats:bold>.</jats:bold></jats:p> </jats:sec><jats:sec> <jats:title>Conclusion</jats:title> <jats:p>The results of this study suggest that increasing age is associated with increased mortality in VTA patients. Compared to the middle-aged, older patients were associated with higher all-cause mortality at 2.5 years and the secondary endpoints.</jats:p> </jats:sec>

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