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

Publikation: Bidrag til tidsskriftTidsskriftartikelForskningfagfællebedømt

  • Mads Wissenberg
  • Carolina Malta Hansen
  • Fredrik Folke
  • Lippert, Freddy
  • Peter Weeke
  • Lena Karlsson
  • Shahzleen Rajan
  • Kathrine Bach Søndergaard
  • Kristian Kragholm
  • Erika Frischknecht Christensen
  • Søren L Nielsen
  • Køber, Lars Valeur
  • Gunnar H Gislason
  • Christian Torp-Pedersen

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.

OriginalsprogEngelsk
TidsskriftResuscitation
Vol/bind85
Udgave nummer9
Sider (fra-til)1212–1218
Antal sider7
ISSN0300-9572
DOI
StatusUdgivet - sep. 2014

ID: 138169905