Cardiac arrest, gender and resuscitation outcomes

Helviz, Yigal; Ong, Marcus Eng Hock; Einav, Sharon

doi:10.1007/s00134-018-5487-z

Cited by 14 publications

(12 citation statements)

References 21 publications

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“…Recently, an increasing number of studies have focused on the effect of gender on outcome of cardiac arrest [ 5 , 6 ]. The epidemiological investigation results showed that female and male victims differed significantly in characteristics of baseline and CPR.…”

Section: Introductionmentioning

confidence: 99%

Interaction between gender and post resuscitation interventions on neurological outcome in an asphyxial rat model of cardiac arrest

Wang

Chen

et al. 2021

BMC Cardiovasc Disord

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Purpose Previous clinical studies have suggested an effect of gender on outcome after out-of-hospital cardiac arrest, but the results are conflicting and there is no uniform agreement regarding gender differences in survival and prognosis. The present study was aimed to investigate the interaction between gender and post resuscitation interventions on neurological outcome in an asphyxial rat model of cardiac arrest. Methods Asphyxia was induced by blocking the endotracheal tube in 120 adult Sprague–Dawley rats (60 males and 60 females) at the same age. Cardiopulmonary resuscitation (CPR) was started after 5 min of untreated cardiac arrest. Animals were randomized into one of the three post resuscitation care intervention groups (n = 40, 20 males) immediately after resuscitation: (1) normothermic control (NC): ventilated with 2% N2/98% O2 for 1 h under normothermia; (2) targeted temperature management (TTM): ventilated with 2% N2/98% O2 for 1 h under hypothermia; (3) hydrogen inhalation (HI): ventilated with 2% H2/98% O2 for 1 h under normothermia. Physiological variables were recorded during the 5 h post resuscitation monitoring period. Neurological deficit score (NDS) and accumulative survival were used to assess 96 h outcomes. Mutual independence analysis and Mantel–Haenszel stratified analysis were used to explore the associations among gender, intervention and survival. Results The body weights of female rats were significantly lighter than males, but CPR characteristics did not differ between genders. Compared with male rats, females had significantly lower mean arterial pressure, longer onset time of the electroencephalogram (EEG) burst and time to normal EEG trace (TTNT) in the NC group; relatively longer TTNT in the TTM group; and substantially longer TTNT, lower NDSs, and higher survival in the HI group. Mutual independence analysis revealed that both gender and intervention were associated with neurological outcome. Mantel–Haenszel stratified analysis demonstrated that female rats had significantly higher survival rate than males when adjusted for the confounder intervention. Conclusion In this rat model cardiac arrest and CPR, gender did not affect resuscitation but associated with neurological outcome. The superiority of female rats in neurological recovery was affected by post resuscitation interventions and female rats were more likely to benefit from hydrogen therapy.

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Section: Introductionmentioning

confidence: 99%

Interaction between gender and post resuscitation interventions on neurological outcome in an asphyxial rat model of cardiac arrest

Wang

Chen

et al. 2021

BMC Cardiovasc Disord

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“…Especially in the case of cardiac arrest (CA), one would assume that "symptoms of death are incontrovertible", as Helviz et al once stated [1]. Furthermore, it is interesting that especially after a perfectly standardized procedure, such as cardiopulmonary resuscitation (CPR), significant differences regarding outcome were observed in various studies in the past [1]. Different authors have examined epidemiological, directly procedure-related, as well as outcome parameters and not all of them are in line.…”

Section: Introductionmentioning

confidence: 99%

“…Different authors have examined epidemiological, directly procedure-related, as well as outcome parameters and not all of them are in line. In many studies male individuals are younger when facing cardiac arrest, show initially shockable rhythms more often and tend to suffer an arrest in public places more frequently, whereas a difference regarding bystander CPR cases could not be observed by all authors [1][2][3][4][5]. It was also shown that women are less likely to receive guidelinecompliant CPR and face differences in postresuscitation care, such as targeted temperature management (TTM) or percutaneous coronary interventions (PCI) [2,3].…”

Section: Introductionmentioning

confidence: 99%

“…Regarding outcome, contradictory results were observed. Some authors described a better outcome in female patients, while others reported reverse findings [ 1 ]. With respect to neurological outcome, in some studies indifferent results were observed but there was a trend towards a worse outcome for female patients [ 1 ].…”

Section: Introductionmentioning

confidence: 99%

“…Some authors described a better outcome in female patients, while others reported reverse findings [ 1 ]. With respect to neurological outcome, in some studies indifferent results were observed but there was a trend towards a worse outcome for female patients [ 1 ]. Whether it is due to women often facing cardiac arrest at home alone, initial electrocardiography (ECG) findings differ between men and women or if general pathophysiological differences exist, need to be determined.…”

Section: Introductionmentioning

confidence: 99%

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Mortality after cardiopulmonary resuscitation on a medical ICU

Rezar

Wernly

Haslinger

et al. 2021

Wien Klin Wochenschr

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Summary Background Performing cardiopulmonary resuscitation (CPR) and postresuscitation care in the intensive care unit (ICU) are standardized procedures; however, there is evidence suggesting sex-dependent differences in clinical management and outcome variables after cardiac arrest (CA). Methods A prospective analysis of patients who were hospitalized at a medical ICU after CPR between December 2018 and March 2020 was conducted. Exclusion criteria were age < 18 years, hospital length of stay < 24 h and traumatic CA. The primary study endpoint was mortality after 6 months and the secondary endpoint neurological outcome assessed by cerebral performance category (CPC). Differences between groups were calculated by using U‑tests and χ2-tests, for survival analysis both univariate and multivariable Cox regression were fitted. Results A total of 106 patients were included and the majority were male (71.7%). No statistically significant difference regarding 6‑month mortality between sexes could be shown (hazard risk, HR 0.68, 95% confidence interval, CI 0.35–1.34; p = 0.27). Neurological outcome was also similar between both groups (CPC 1 88% in both sexes after 6 months; p = 1.000). There were no statistically significant differences regarding general characteristics, pre-existing diseases, as well as the majority of clinical and laboratory parameters or measures performed on the ICU. Conclusion In a single center CPR database no statistically significant sex-specific differences regarding post-resuscitation care, survival and neurological outcome after 6 months were observed.

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