Effect of gender on out-of-hospital cardiac arrest survival: a registry-based study

Hubert, Hervé; Jaeger, Déborah; Baert, Valentine; Vilhelm, Christian; Génin, Michaël; Manzo-Silberman, Stéphane; Sadoune, Sonia; Denayer, Franck‐Olivier; Javaudin, François; Gueugniaud, Pierre‐Yves; Tazarourte, Karim; Mounier‐Véhier, Claire; Khoury, Carlos El; Chouihed, Tahar

doi:10.1097/mej.0000000000000747

Cited by 9 publications

(19 citation statements)

References 32 publications

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“…In the reproductive age group (18–44 years), in which all variables, except for good post-arrest CPC scale score variable, were matched, women had better rates of ROSC at the scene or in the ED, survival-to-admission, and survival-to-discharge. Previous studies have also shown similar results to ours [ 20 , 23 ].…”

Section: Discussionsupporting

confidence: 92%

“…[ 20 ] reported different results. In the final adjusted logistic model, the subgroup of patients over 55 years old, had no difference in survival outcomes, which was consistent with the findings of a previous study [ 23 ]. In the reproductive age group (18–44 years), in which all variables, except for good post-arrest CPC scale score variable, were matched, women had better rates of ROSC at the scene or in the ED, survival-to-admission, and survival-to-discharge.…”

Section: Discussionsupporting

confidence: 90%

“…Hubert et al . [ 23 ] demonstrated the same results as ours, but Ng et al . [ 20 ] reported different results.…”

Section: Discussionsupporting

confidence: 84%

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Gender effect in survival after out-of-hospital cardiac arrest: A nationwide, population-based, case-control propensity score matched study based Korean national cardiac arrest registry

Choi

Chang

et al. 2022

PLoS ONE

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Objective This study aimed to describe the relationship between sex and survival of patients with out-of-hospital cardiac arrest (OHCA) and further investigate the potential impact of female reproductive hormones on survival outcomes, by stratifying the patients into two age groups. Methods This retrospective, national population-based observational, case-control study, included Korean OHCA data from January 1, 2009, to December 31, 2016. We used multiple logistic regression with propensity score-matched data. The primary outcome was survival-to-discharge. Results Of the 94,160 patients with OHCA included, 34.2% were women. Before propensity score matching (PSM), the survival-to-discharge rate was 5.2% for females and 9.1% for males, in the entire group (OR 0.556, 95% CI [–0.526–0.588], P<0.001). In the reproductive age group (age 18–44 years), the survival-to-discharge rate was 14% for females and 15.6% for males (OR 0.879, 95% CI [0.765–1.012], P = 0,072) and in the post-menopause age group (age ≥ 55 years), the survival-to-discharge rate was 4.1% for females and 7% for males (OR 0.562, 95% CI [0.524–0.603], P<0.001). After PSM (28,577 patients of each sex), the survival-to-discharge rate was 5.4% for females and 5.4% for males (OR, 1.009 [0.938–1.085], P = 0.810). In the reproductive age group, the survival-to-discharge rate was 14.5% for females and 11.5% for males (OR 1.306, 95% CI [1.079–1.580], P = 0.006) and in the post-menopause age group, the survival-to-discharge rate was 4.2% for females and 4.6% for males (OR 0.904, 95% CI [0.828–0.986], P = 0.022). After adjustment for confounders, women of reproductive age were more likely to survive at hospital discharge. However, there was no statistically significant difference in neurological outcome (OR 1.238, 95% CI [0.979–1.566], P = 0.074). Conclusions Females of reproductive age had a better chance of survival when matched for confounding factors. Further studies using sex hormones are needed to improve the survival rate of patients with OHCA.

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Section: Discussionsupporting

confidence: 92%

Section: Discussionsupporting

confidence: 90%

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Gender effect in survival after out-of-hospital cardiac arrest: A nationwide, population-based, case-control propensity score matched study based Korean national cardiac arrest registry

Choi

Chang

et al. 2022

PLoS ONE

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“…Likewise, disparities exist between ethnicities with minority ethnic groups consistently having poorer survival [11,34,67]. Men appear to have an improved survival to hospital discharge compared to women [39,64], however, this finding is variable within the present literature [68,69]. Disparities also exist amongst 30-day survivors, with those of lower socio-economic status having poorer long-term survival [70 & ].…”

Section: Post Resuscitation Carementioning

confidence: 99%

Health inequities in out-of-hospital cardiac arrest

Boulton

Rios

Perkins

2022

Current Opinion in Critical Care

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Purpose of review Out-of-hospital cardiac arrest (OHCA) is a time-critical emergency in which a rapid response following the chain of survival is crucial to save life. Disparities in care can occur at each link in this pathway and hence produce health inequities. This review summarises the health inequities that exist for OHCA patients and suggests how they may be addressed. Recent findings There is international evidence that the incidence of OHCA is increased with increasing deprivation and in ethnic minorities. These groups have lower rates of bystander CPR and bystander-initiated defibrillation, which may be due to barriers in accessing cardiopulmonary resuscitation training, provision of public access defibrillators, and language barriers with emergency call handlers. There are also disparities in the ambulance response and in-hospital care following resuscitation. These disadvantaged communities have poorer survival following OHCA. Summary OHCA disproportionately affects deprived communities and ethnic minorities. These groups experience disparities in care throughout the chain of survival and this appears to translate into poorer outcomes. Addressing these inequities will require coordinated action that engages with disadvantaged communities.

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“…Sex differences affect patient outcomes in many diseases, such as Coronavirus Disease 2019 (COVID- 19), acute myocardial infarction, acute ischemic stroke and infectious diseases, while outcome differences in out of hospital cardiac arrest are still controversial [1][2][3][4][5][6][7]. Male sex was found to be an independent predictor of mortality in the Emergency Department (ED) [8][9][10][11], but it is unclear whether this higher risk for men is caused by male sex itself, by higher disease severity at ED presentation, or by sex related differences in the recognition and treatment of patients at risk in the ED.…”

Section: Introductionmentioning

confidence: 99%

Sex differences in clinical presentation and risk stratification in the Emergency Department: An observational multicenter cohort study

Candel

Dap

Raven

et al. 2022

European Journal of Internal Medicine

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The aim of this study was to investigate whether sex differences exist in disease presentations, disease severity and (case-mix adjusted) outcomes in the Emergency Department (ED). Methods: Observational multicenter cohort study using the Netherlands Emergency Department Evaluation Database (NEED), including patients ≥ 18 years of three Dutch EDs. Multivariable logistic regression was used to study the associations between sex and outcome measures in-hospital mortality and Intensive Care Unit/Medium Care Unit (ICU/MCU) admission in ED patients and in subgroups triage categories and presenting complaints. Results: Of 148,825 patients, 72,554 (48.8%) were females. Patient characteristics at ED presentation and diagnoses (such as pneumonia, cerebral infarction, and fractures) were comparable between sexes at ED presentation. In-hospital mortality was 2.2% in males and 1.7% in females. ICU/MCU admission was 4.7% in males and 3.1% in females. Males had higher unadjusted )) and adjusted (AOR 1.34(1.24-1.46)) risks for mortality, and unadjusted (OR 1.54(1.46-1.63)) and adjusted (AOR 1.46(1.37-1.56)) risks for ICU/MCU admission. Males had higher adjusted mortality and ICU/MCU admission for all triage categories, and with almost all presenting complaints except for headache. Conclusions: Although patient characteristics at ED presentation for both sexes are comparable, males are at higher unadjusted and adjusted risk for adverse outcomes. Males have higher risks in all triage categories and with almost all presenting complaints. Future studies should investigate reasons for higher risk in male ED patients.

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Effect of gender on out-of-hospital cardiac arrest survival: a registry-based study

Cited by 9 publications

References 32 publications

Gender effect in survival after out-of-hospital cardiac arrest: A nationwide, population-based, case-control propensity score matched study based Korean national cardiac arrest registry

Gender effect in survival after out-of-hospital cardiac arrest: A nationwide, population-based, case-control propensity score matched study based Korean national cardiac arrest registry

Health inequities in out-of-hospital cardiac arrest

Sex differences in clinical presentation and risk stratification in the Emergency Department: An observational multicenter cohort study

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