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Gender differences and survival after out of hospital cardiac arrest - 15/04/22

Doi : 10.1016/j.ajem.2022.02.032 
Daniel Rob, MD a, , Petra Kavalkova, PhD a, Jana Smalcova, MD a, Ondrej Franek, MD b, Ondrej Smid, MD a, Arnost Komarek, PhD c, Michael Pisinger, MD d, Jan Belohlavek, MD, PhD a
a 2nd Department of Medicine – Department of Cardiovascular Medicine, First Faculty of Medicine, Charles University in Prague and General University Hospital in Prague, Czech Republic 
b Emergency Medical Service Prague, Czech Republic 
c Department of Probability and Mathematical Statistics, Faculty of Mathematics and Physics, Charles University in Prague, Czech Republic 
d Department of Cardiology, Hospital Ceske Budejovice, a.s., Czech Republic 

Corresponding author at: 2nd Department of Medicine – Department of Cardiovascular Medicine, First Faculty of Medicine, Charles University and General University Hospital in Prague, U Nemocnice 2, 128 08 Praha 2, Czech Republic.2nd Department of Medicine – Department of Cardiovascular MedicineFirst Faculty of MedicineCharles University and General University Hospital in PragueU Nemocnice 2128 08 Praha 2Czech Republic

Abstract

Background

Published evidence regarding the effect of gender on outcome after out of hospital cardiac arrest (OHCA) is inconsistent. We aimed to investigate the association of gender to outcome and resuscitation characteristics in OHCA patients admitted to the cardiac arrest center.

Methods

In this retrospective analysis of prospective registry data, all patients admitted for OHCA were included. The influence of gender on 30-day survival and good neurological outcome (cerebral performance category of 1 or 2) were examined using Kaplan-Meier estimates and multivariable logistic regression.

Results

In total, 932 patients were analysed (239 women, 26%). Women were older (64 vs 60 years, p < 0.001) and less commonly had a shockable rhythm (47% vs 65%, P < 0.001) compared to men. Women were less likely to have a cardiac cause of arrest (54% vs. 75%, p < 0.001), received less therapeutic hypothermia (74% vs 86%, p < 0.001) and coronary angiography (63% vs. 79%, p < 0.001). The overall 30-day survival was lower for women (45% vs. 53%, log-rank p = 0.005) as well as good neurological outcome (37% vs. 46%, p = 0.008). However, according to the multivariate logistic regression, gender was not associated with survival (OR 0.98, 95% CI 0.65–1.50, p = 0.94) nor with good neurological outcome (OR 0.91, 95% CI 0.59–1.40, p = 0.67).

Conclusion

Women admitted for OHCA to a cardiac center had a different cause of arrest that had a different treatment and outcome compared to men. Survival and good neurological outcome were lower in women, however, after adjusting for baseline characteristics, gender was not associated with survival nor neurological outcome.

Il testo completo di questo articolo è disponibile in PDF.

Highlights

Women admitted for OHCA to a cardiac arrest center had a different cause of arrest compared to men.
Survival and good neurological outcome after OHCA were lower in women compared to men.
Women admitted for OHCA to a cardiac arrest center are treated less aggressively compared to men.

Il testo completo di questo articolo è disponibile in PDF.

Keywords : Cardiac arrest, Sex, Gender, Women, Resuscitation, Outcome


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