Associations between gender and cardiac arrest outcomes in Pan-Asian out-of-hospital cardiac arrest patients

Ng, Yih Yng; Wah, Win; Liu, Nan; Zhou, Sheng Ang; Ho, Andrew Fu Wah; Pek, Pin Pin; Shin, Sang Do; Tanaka, Hideharu; Khunkhlai, Nalinas; Lin, Chih‐Hao; Wong, Kwanhathai Darin; Cai, Wei; Huei‐Ming, Matthew

doi:10.1016/j.resuscitation.2016.03.002

Cited by 61 publications

(65 citation statements)

References 22 publications

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“…(26) However, the effect of gender on hospital survival of OHCA was not significant, as previous studies have described. (24,25) According to a recent retrospective survey in Sweden, there was no association between urbanization and outcomes after OHCA, consistent with our discovery. (27) In contrast with urbanization, higher level of hospital care, such as in a medical center, was associated with successful ROSC in our report.…”

Section: Discussionsupporting

confidence: 89%

Major interventions are associated with survival of out of hospital cardiac arrest patients - a population based survey

Chen

Hung²,

Chang³

et al. 2017

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Background. The overall survival rate of out-of-hospital cardiac arrest (OHCA) in Taiwan or even in the whole of Asia is relatively low. Major interventions, such as target temperature management (TTM), coronary artery angiography, and extracorporeal membrane oxygenation (ECMO), have been associated with better patient outcome. However, studies in Taiwan revealing evidence of the benefits of these interventions are limited. Methods. A population-based study used an 8-year database to analyze overall survival and risk factors ˝among OHCA patients. All adult non-trauma OHCA patients were identified through diagnostic and procedure codes. Hospital survival and return of spontaneous circulation (ROSC) were primary and secondary outcomes. Logistic regression and Cox regression analyses were conducted. Results. There was a relationship between major interventions (including TTM, coronary artery angiography, and ECMO) and better hospital survival. Age, income, major interventions, and acute myocardial infarction history were associated with hospital survival. The adjusted hazard ratios (HRs) were 0.406 (95% CI, 0.295 to 0.558), 1.109 (95% CI, 1.027 to 1.197), 1.075 (95% CI, 1.002 to 1.154), 1.097 (95% CI, 1.02 to 1.181) and 0.799(95% CI, 0.677 to 0.942) for patients with major interven-

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Section: Discussionsupporting

confidence: 89%

Major interventions are associated with survival of out of hospital cardiac arrest patients - a population based survey

Chen

Hung²,

Chang³

et al. 2017

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“…[20][21][22] Furthermore, females in the reproductive age group (18-44 years) were more likely to have return of spontaneous circulation and cerebral performance outcomes compared to menopausal women (age 55 years and above). 20 This may translate eventually to better survival to hospital arrival despite less favourable baseline variables in women. 22 However, whether women may be associated with better survival to hospital discharge depending on their age is controversial.…”

Section: Discussionmentioning

confidence: 98%

“…Focusing on outcomes of OHCA patients and their underlying arrhythmias at index presentation, it was demonstrated that women more often present with non‐shockable index arrhythmias (i.e. pulseless electrical activity (PEA)) and asystole compared to males (rates of PEA/asystole in females compared to males: up to 91% versus 80%) . Furthermore, females in the reproductive age group (18–44 years) were more likely to have return of spontaneous circulation and cerebral performance outcomes compared to menopausal women (age 55 years and above) .…”

Section: Discussionmentioning

confidence: 99%

“…pulseless electrical activity (PEA)) and asystole compared to males (rates of PEA/asystole in females compared to males: up to 91% versus 80%) . Furthermore, females in the reproductive age group (18–44 years) were more likely to have return of spontaneous circulation and cerebral performance outcomes compared to menopausal women (age 55 years and above) . This may translate eventually to better survival to hospital arrival despite less favourable baseline variables in women .…”

Section: Discussionmentioning

confidence: 99%

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Male sex increases mortality in ventricular tachyarrhythmias

Weidner

Behnes

Rusnak

et al. 2019

Internal Medicine Journal

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Background Ventricular tachyarrhythmias are still associated with poor clinical outcomes. Therefore, it is important to stratify high‐risk patients presenting with ventricular tachyarrhythmias for their individual risk of future outcomes. Aim To assess the impact of male sex on survival in patients presenting with ventricular tachyarrhythmias. Methods All consecutive patients surviving ventricular tachycardia (VT) and fibrillation (VF) on admission from 2002 to 2016 were included and stratified according to sex differences by propensity score matching. The primary prognostic end‐point was all‐cause mortality at 30 months. Secondary end‐points were all‐cause mortality at 30 days, at index hospitalisation, after discharge, the composite of recurrent ventricular tachyarrhythmias and appropriate implantable cardioverter defibrillator (ICD) therapies, and finally rehospitalisation related to ventricular tachyarrhythmias. Results A total of 784 (392 males and 392 females) matched patients was included. The rate of VT and VF was similar in both groups (VT: male 65% vs female 62%; VF: male 35% vs female 38%). Male sex was independently associated with the primary end‐point of all‐cause mortality at 30 months (31% vs 23%; hazard ratio (HR) = 1.432; 95% confidence interval (CI) 1.089–1.883; P = 0.010) as well as with the secondary end‐point of all‐cause mortality at index hospitalisation (mortality rate 31% vs 23%; log‐rank P = 0.010; HR = 1.432; 95% CI 1.089–1.883; P = 0.010; mortality rate 10% vs 15%; HR = 1.685; 95% CI 1.117–2.542; P = 0.013). No differences in further secondary end‐points were found. Sex differences of the primary end‐point were predominantly observed in patients with VT at index (mortality rate 28% versus 20%; HR = 1.512; 95% CI 1.040–2.189; P = 0.028), without an ICD and with left ventricular ejection fraction ≥35% (log‐rank values, P < 0.05). Conclusion Males presenting with ventricular tachyarrhythmias on admission were associated with higher all‐cause mortality at 30 months and all‐cause mortality at index hospitalisation.

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“…One traditional interim outcome measure is survival to hospital discharge. Conflicting data exist regarding the association between sex and the likelihood of discharge from hospital following OHCA-some studies show better outcomes in women [2,6,7], some demonstrate similar outcomes [8][9][10], and some show worse outcomes compared with men [4,11]. Another interim outcome measure is the rate of neurologically intact survival at the time of hospital discharge.…”

mentioning

confidence: 99%