Aims Little is known about the difference in outcomes between young and old patients who received extracorporeal cardiopulmonary resuscitation (ECPR) for out-of-hospital cardiac arrest (OHCA). Therefore, we aimed to investigate the differences in outcomes between those aged ≥75 years and <75 years who experienced OHCA and were resuscitated with ECPR. Methods and results We performed a secondary analysis of a nationwide prospective cohort study using the Japanese Association for Acute Medicine OHCA registry. We identified patients aged ≥18 years with OHCA who received ECPR. The patients were classified into three age groups (18–59 years, 60–74 years, and ≥75 years). The primary outcome was a 1-month neurological outcome. To examine the association between age and 1-month neurological outcome, we performed logistic regression analyses fitted with generalized estimating equations. From 2014 to 2017, we identified 875 OHCA patients aged ≥18 years who received ECPR. The proportion of patients who survived with favourable neurological outcome in the patients aged 18–59 years, 60–74 years, and ≥75 years were 15% (64/434), 8.9% (29/326), and 1.7% (2/115), respectively. In the multivariable analysis, compared with the age of 18–59 years, the proportions of favourable neurological outcomes were significantly lower in patients aged 60–74 years [adjusted odds ratio (OR), 0.44; 95% confidence interval (CI), 0.32–0.61] and those aged ≥75 years (adjusted OR, 0.26; 95% CI, 0.11–0.59). Conclusion Advanced age (age ≥75 years in particular) was significantly associated with poor neurological outcomes in patients with OHCA who received ECPR.

中文翻译：

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经体外心肺复苏术复苏的院外心脏骤停患者的年龄与神经系统结局之间的关联：一项全国性多中心观察研究

目标 对于因院外心脏骤停 (OHCA) 接受体外心肺复苏 (ECPR) 的年轻和老年患者的结局差异知之甚少。因此，我们旨在调查那些经历过 OHCA 并通过 ECPR 复苏的年龄≥​​75 岁和 <75 岁之间的结果差异。方法和结果 我们使用日本急性医学会 OHCA 登记处对一项全国性前瞻性队列研究进行了二次分析。我们确定了接受 ECPR 的年龄≥18 岁的 OHCA 患者。将患者分为三个年龄组（18-59 岁、60-74 岁和≥75 岁）。主要结果是 1 个月的神经系统结果。为了检查年龄和 1 个月神经系统结果之间的关联，我们进行了符合广义估计方程的逻辑回归分析。从 2014 年到 2017 年，我们确定了 875 名接受 ECPR 的年龄≥18 岁的 OHCA 患者。在 18-59 岁、60-74 岁和≥75 岁的患者中，神经系统预后良好的存活患者比例分别为 15% (64/434)、8.9% (29/326) 和 1.7% (2 /115），分别。在多变量分析中，与 18-59 岁相比，60-74 岁患者的良好神经系统结局的比例显着降低[调整优势比 (OR)，0.44；95% 置信区间 (CI), 0.32–0.61] 和年龄 ≥ 75 岁的人 (调整后的 OR, 0.26; 95% CI, 0.11–0.59)。结论 高龄（特别是年龄≥75 岁）与接受 ECPR 的 OHCA 患者的不良神经系统预后显着相关。