Difference in Determinants of Long-Term Prognosis of Patients with Out-of-Hospital Cardiac Arrests in Different Generations

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Background: Sudden cardiac death is a serious problem in public health and it affects >110,000/year in Japan. We retrospectively analyzed patients with OHCAs in our institute to clarify the configurations of cardiac diseases as the cause of OHCAs and determinants of prognosis in different patient generations. Methods and Results: We analyzed 449 consecutive patients (age 72±1, M:F=274:175) with cardiac cause (January/2009–June/2010). Because the survival rate was remarkably different, the patients were divided into 2 groups by the age of 70 (<70: n=169, ≥70: n=281). The cardiac causes were classified into 3 categories; 1) ischemic heart disease (IHD), 2) heart failure (HF), and 3) arrhythmias (VT/VF). The configurations of cardiac causes (IHD:HF:VT/VF) were 103:50:16 in <70, and were 252:25:4 in ≥70 (p<0.001). In <70, 1 month-survivors and patients with favorable neurological outcome were 32 and 25, but were 9 and 5 in ≥70 (p<0.0001. When compared between survivors and non-survivors, the incidence of VT/VF were higher in survivors in <70 (10/32 vs. 6/136, p<0.0001), but the incidence of HF was higher in survivors in ≥70 (5/9 vs. 20/272, p<0.001). Conclusion: The configurations of cardiac causes of OHCAs were different in different generations. In younger generation, the determinant of better prognosis was VT/VF, but was HF in elder generation.