Survival after out-of-hospital cardiac arrest in relation to sex: a nationwide registry-based study.

Abstract:

AIM:Crude survival has increased following an out-of-hospital cardiac arrest (OHCA). We aimed to study sex-related differences in patient characteristics and survival during a 10-year study period. METHODS:Patients≥12 years old with OHCA of a presumed cardiac cause, and in whom resuscitation was attempted, were identified through the Danish Cardiac Arrest Registry 2001-2010. A total of 19,372 patients were included. RESULTS:One-third were female, with a median age of 75 years (IQR 65-83). Compared to females, males were five years younger; and less likely to have severe comorbidities, e.g., chronic obstructive pulmonary disease (12.8% vs. 16.5%); but more likely to have arrest outside of the home (29.4% vs. 18.7%), receive bystander CPR (32.9% vs. 25.9%), and have a shockable rhythm (32.6% vs. 17.2%), all p<0.001. Thirty-day crude survival increased in males (3.0% in 2001 to 12.9% in 2010); and in females (4.8% in 2001 to 6.7% in 2010), p<0.001. Multivariable logistic regression analyses adjusted for patient characteristics including comorbidities, showed no survival difference between sexes in patients with a non-shockable rhythm (OR 1.00; CI 0.72-1.40), while female sex was positively associated with survival in patients with a shockable rhythm (OR 1.31; CI 1.07-1.59). Analyses were rhythm-stratified due to interaction between sex and heart rhythm; there was no interaction between sex and calendar-year. CONCLUSIONS:Temporal increase in crude survival was more marked in males due to poorer prognostic characteristics in females with a lower proportion of shockable rhythm. In an adjusted model, female sex was positively associated with survival in patients with a shockable rhythm.

journal_name

Resuscitation

journal_title

Resuscitation

authors

Wissenberg M,Hansen CM,Folke F,Lippert FK,Weeke P,Karlsson L,Rajan S,Søndergaard KB,Kragholm K,Christensen EF,Nielsen SL,Køber L,Gislason GH,Torp-Pedersen C

doi

10.1016/j.resuscitation.2014.06.008

subject

Has Abstract

pub_date

2014-09-01 00:00:00

pages

1212-8

issue

9

eissn

0300-9572

issn

1873-1570

pii

S0300-9572(14)00597-8

journal_volume

85

pub_type

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