Association of gender to outcome after out-of-hospital cardiac arrest – a report from the International Cardiac Arrest Registry

Karlsson, Viktor; Dankiewicz, Josef; Nielsen, Niklas; Kern, Karl B.; Mooney, M.; Riker, Richard R.; Rubertsson, Sten; Seder, David B.; Stammet, Pascal; Sunde, Kjetil; Søreide, Eldar; Unger, Barbara; Friberg, Hans

doi:10.1186/s13054-015-0904-y

Cited by 98 publications

(124 citation statements)

References 39 publications

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“…This has been associated with the presence of different comorbidities. In men coronary artery disease was observed more frequently, while in women more chronic obstructive pulmonary disease was seen [12]. In our research we found that the occurrence of prehospital ROSC does not depend on gender.…”

Section: Discussionsupporting

confidence: 44%

Emergency medical system response time does not affect incidence of return of spontaneous circulation after prehospital resuscitation in one million central European agglomeration residents

Kłosiewicz

Skitek-Adamczak²,

Zieliński³

2017

Kardiol Pol

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A b s t r a c t Background:The survival of out-of-hospital sudden cardiac arrest (OHSCA) in Europe still remains low. The State Medical Rescue System is composed of several elements. The efficacy of each of these elements may have an influence on the victim's survival. Until now, the incidence of return of spontaneous circulation (ROSC) and its correlation with rescue services time in the city of Poznan has not been determined. Aim:The main purpose of this study was to assess incidents of OHSCA and prehospital frequency of ROSC after OHSCA in Poznan city and district. We also wanted to analyse whether ROSC depends on Emergency Medical System (EMS) reaction time. Methods: Retrospective analysis based on medical documentation conducted in 2015 in Poznan EMS.Results: Return of spontaneous circulation was achieved in 68.88% of cases. It was most frequent when OHSCA occurred in public places (p = 0.000, contingency factor = 0.233) and victims were younger (p = 0.042, contingency factor = 0.129). 63.17% of patients were male, but sex did not affect the incidence of ROSC. The median time of system response was 8.53 min, while time from ambulance departure to arrival was 5.42 min. We did not find any statistically significant difference between the number of deaths and those parameters (p = 0.723, p = 0.891). However, longer team response time correlated with the highest mortality (p = 0.042, contingency factor = 0.126). In the group where ROSC was achieved the median time of EMS response was 8.18 min, while among the group of deceased the median was 8.63 min. Conclusions:The incidence of OHSCA in our region is similar to other Polish and European cities. EMS response time does not affect the frequency of ROSC. ROSC was achieved more often if OHSCA occurred in public and the victim was younger.

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Section: Discussionsupporting

confidence: 44%

Emergency medical system response time does not affect incidence of return of spontaneous circulation after prehospital resuscitation in one million central European agglomeration residents

Kłosiewicz

Skitek-Adamczak²,

Zieliński³

2017

Kardiol Pol

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“…W badaniu tym po zidentyfikowaniu i uwzględnieniu odmienności w obu grupach płci, płeć żeńska związana była jednak tylko z nieistotną statystycznie poprawą przeżycia NZK [20]. Wyż-szą śmiertelność wśród kobiet obserwowano natomiast w pozaszpitalnym NZK [21].…”

Section: Dyskusjaunclassified

Ocena częstości występowania wewnątrzszpitalnego nagłego zatrzymania krążenia w Polsce

Adamski¹,

Nowakowski²,

Goryński³

et al. 2016

Anaesthesiol Intensive Ther

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Background: In-hospital cardiac arrest with its poor prognosis is a challenging problem in hospitals. The aim of this study was to evaluate in Polish hospitals the frequency of in-hospital cardiac arrests with the subsequent mortality, with special emphasis on the type of unit at which the event occurred, and the patient's demographic data, such as age and sex. Methods: The study was a retrospective analysis of data for 2012 registered in the Polish General Hospital Morbidity Study. This research covered all Polish hospitals, excluding only government and psychiatric hospitals. The study inclusion criterion was the incidence of cardiac arrest in any hospital ward, recorded by the respective ICD-10 diagnosis code. Results: Of the 7,775,553 patients hospitalized, the diagnosis of cardiac arrest was reported in a total of 22,602 patients, which included 22,317 adults (98.7% of all patients) and 285 children (1.3%). Overall mortality after cardiac arrest among adults was 74.2%, and in children 46.7%. In both absolute numbers and as percentages of all documented cases, cardiac arrests occurred most often at the departments of intensive care, internal medicine, cardiology and emergency medicine. The accompanying mortal ity was lower than average at the departments of intensive care, cardiology, cardiology high dependency unit and emergency medicine. The median age of patients with cardiac arrest who died in the hospital was higher than the median age of those who survived (72 vs. 64; P < 0.05). Although cardiac arrests were reported more often among men than women (58.2% vs. 41.8%; P < 0.001), the hospital mortality was higher among women (79.2% vs. 71.6%; P < 0.001). Conclusion:The frequency of in-hospital cardiac arrests in Polish hospitals and the subsequent mortality is not substantially different from that observed in other countries. However, our study, based on ICD-10 diagnosis codes, gives only limited information about the patients and circumstances of this event. An in-depth analysis of the causes, prognoses, and outcome of in-hospital cardiac arrests could be facilitated by the creation of a national registry.

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“…In contrast, sex‐related differences in interventions that may highly impact survival, such as bystander or first‐responder resuscitation efforts, are presumably modifiable. Recent European studies found that female sex was associated with lower rates of bystander cardiopulmonary resuscitation (CPR) and early defibrillation, even among witnessed cardiac arrests 2, 5, 12, 13. It is unclear whether such differences also exist in contemporary US cardiac arrest populations.…”

Section: Introductionmentioning

confidence: 99%

Association of Bystander and First‐Responder Efforts and Outcomes According to Sex: Results From the North Carolina HeartRescue Statewide Quality Improvement Initiative

Hansen

Kragholm

Dupre

et al. 2018

JAHA

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BackgroundThe Institute of Medicine has called for actions to understand and target sex‐related differences in care and outcomes for out‐of‐hospital cardiac arrest patients. We assessed changes in bystander and first‐responder interventions and outcomes for males versus females after statewide efforts to improve cardiac arrest care.Methods and ResultsWe identified out‐of‐hospital cardiac arrests from North Carolina (2010–2014) through the CARES (Cardiac Arrest Registry to Enhance Survival) registry. Outcomes for men versus women were examined through multivariable logistic regression analyses adjusted for (1) nonmodifiable factors (age, witnessed status, and initial heart rhythm) and (2) nonmodifiable plus modifiable factors (bystander cardiopulmonary resuscitation and defibrillation before emergency medical services), including interactions between sex and time (ie, year and year2). Of 8100 patients, 38.1% were women. From 2010 to 2014, there was an increase in bystander cardiopulmonary resuscitation (men, 40.5%–50.6%; women, 35.3%–51.8%; P for each <0.0001) and in the combination of bystander cardiopulmonary resuscitation and first‐responder defibrillation (men, 15.8%–23.0%, P=0.007; women, 8.5%–23.7%, P=0.004). From 2010 to 2014, the unadjusted predicted probability of favorable neurologic outcome was higher and increased more for men (men, from 6.5% [95% confidence interval (CI), 5.1–8.0] to 9.7% [95% CI, 8.1–11.3]; women, from 6.3% [95% CI, 4.4–8.3] to 7.4% [95% CI, 5.5–9.3%]); while adjusted for nonmodifiable factors, it was slightly higher but with a nonsignificant increase for women (from 9.2% [95% CI, 6.8–11.8] to 10.2% [95% CI, 8.0–12.5]; men, from 5.8% [95% CI, 4.6–7.0] to 8.4% [95% CI, 7.1–9.7]). Adding bystander cardiopulmonary resuscitation and defibrillation before EMS (modifiable factors) did not substantially change the results.ConclusionsBystander and first‐responder interventions increased for men and women, but outcomes improved significantly only for men. Additional strategies may be necessary to improve survival among female cardiac arrest patients.

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Association of gender to outcome after out-of-hospital cardiac arrest – a report from the International Cardiac Arrest Registry

Cited by 98 publications

References 39 publications

Emergency medical system response time does not affect incidence of return of spontaneous circulation after prehospital resuscitation in one million central European agglomeration residents

Emergency medical system response time does not affect incidence of return of spontaneous circulation after prehospital resuscitation in one million central European agglomeration residents

Ocena częstości występowania wewnątrzszpitalnego nagłego zatrzymania krążenia w Polsce

Association of Bystander and First‐Responder Efforts and Outcomes According to Sex: Results From the North Carolina HeartRescue Statewide Quality Improvement Initiative

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