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Long-term outcomes and prognostic factors of extracorporeal cardiopulmonary resuscitation in patients older than 75 years: a single-centre retrospective study
  1. Shota Kikuta,
  2. Akihiko Inoue,
  3. Satoshi Ishihara,
  4. Ryo Takahashi,
  5. Shinichi Ijuin,
  6. Shigenari Matsuyama,
  7. Shinichi Nakayama
  1. Emergency and Critical Care Medicine, Hyogo Emergency Medical Center, Kobe, Hyogo, Japan
  1. Correspondence to Dr Shota Kikuta, Emergency and Critical Care Medicine, Hyogo Emergency Medical Center, Kobe, 651-0073, Japan; s-kikuta{at}


Background Few studies have assessed older adult patients who received extracorporeal cardiopulmonary resuscitation (ECPR) after cardiac arrest, and outcomes and prognostic factors of ECPR in this population remain unclear. This study aimed to assess the long-term outcomes and prognostic factors among patients older than 75 years who received ECPR after experiencing cardiac arrest.

Methods This is a single-centre, retrospective case–control study conducted between August 2010 and July 2019. Consecutive patients older than 75 years who had in-hospital (IHCA) or out-of-hospital cardiac arrest (OHCA) and received ECPR at the Emergency Department in the Hyogo Emergency Medical Center, Hyogo, Japan, were included. The primary outcome was a favourable neurological outcome, defined as a Cerebral Performance Category score of 1–2 at 1 year after the event. Univariate logistic regression was used to determine the association between variables and patient outcomes.

Results Of the 187 patients with cardiac arrest who received ECPR, 30 were older than 75 years and 28 (15% of the cohort receiving ECPR) were examined in this study. The median age of the patients was 79 years (IQR 77–82), and there were 13 (46%) male patients. Neurological outcomes were favourable for seven (25%) patients, five of whom had IHCA and two with out-of-hospital OHCA. On univariate analysis, patients with a favourable outcome had a shorter median total collapse time (TCT) than those with an unfavourable outcome (favourable: 18.0 min (IQR 13.0–33.5) vs unfavourable: 44.0 min (IQR 25.0–53.0); p=0.049).

Conclusion In selected patients older than 75 years, ECPR could be beneficial by providing a shorter TCT, which may contribute to favourable neurological outcomes. Nevertheless, further studies are needed to validate these findings.

  • geriatrics

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  • Handling editor Ed Benjamin Graham Barnard

  • SK and AI contributed equally.

  • Contributors All the authors discussed the idea and design of study. Data analysis and first draft writing were done by SK and AI. SK and AI contributed equally to this work. All authors read the draft and provided insight for the final version. S Ishihara, AI, SM, S Ijuin and SN played an important role in the development of our institute’s ECPR protocol. SK contributed to patient data collection. SK and AI the guarantors of the paper, taking responsibility for the integrity of the work as a whole, from inception to published article.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient and public involvement Patients and/or the public were not involved in the design, or conduct, or reporting or dissemination plans of this research.

  • Provenance and peer review Not commissioned; externally peer reviewed.