Higher 1-year mortality in women admitted to intensive care units after cardiac arrest: A nationwide overview from the Netherlands between 2010 and 2018

Mandigers, Loes; Termorshuizen, Fabian; Keizer, Nicolette F. de; Rietdijk, Wim; Gommers, Diederik; Miranda, Dinís Dos Reis; Uil, Corstiaan A. den

doi:10.1016/j.jcrc.2021.04.007

Cited by 3 publications

(5 citation statements)

References 39 publications

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“…We linked a national administrative insurance claims database (Vektis) to the NICE registry, to determine the 1-year mortality as previously reported. 26 , 27 Health insurance is obligatory for all Dutch citizens and 99% have private healthcare insurance. 28 The Vektis databases 29 contain reimbursement data on all medical treatments paid for by Dutch insurance companies, as well as demographic information, such as date of birth, gender, and a proxy for date of death for all registered inhabitants of the Netherlands.…”

Section: Methodsmentioning

confidence: 99%

One-year Mortality of Cancer Patients with an Unplanned ICU Admission: A Cohort Analysis Between 2008 and 2017 in the Netherlands

Zee

Termorshuizen

Benoît

et al. 2021

J Intensive Care Med

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Introduction: A decrease in short-term mortality of critically ill cancer patients with an unplanned intensive care unit (ICU) admission has been described. Few studies describe a change over time of 1-year mortality. Therefore, we examined the 1-year mortality of cancer patients (hematological or solid) with an unplanned ICU admission and we described whether the mortality changed over time. Methods: We used the National Intensive Care Evaluation (NICE) registry and extracted all patients with an unplanned ICU admission in the Netherlands between 2008 and 2017. The primary outcome was 1-year mortality, analyzed with a mixed-effects Cox proportional hazard regression. We compared the 1-year mortality of cancer patients to that of patients without cancer. Furthermore, we examined changes in mortality over the study period. Results: We included 470,305 patients: 10,401 with hematological cancer, 35,920 with solid cancer, and 423,984 without cancer. The 1-year mortality rates were 60.1%, 46.2%, and 28.3% respectively ( P< .01). Approximately 30% of the cancer patients surviving their hospital admission died within 1 year, this was 12% in patients without cancer. In hematological patients, 1-year mortality decreased between 2008 and 2011, after which it stabilized. In solid cancer patients, inspection showed neither an increasing nor decreasing trend over the inclusion period. For patients without cancer, 1-year mortality decreased between 2008 and 2013, after which it stabilized. A clear decrease in hospital mortality was seen within all three groups. Conclusion: The 1-year mortality of cancer patients with an unplanned ICU admission (hematological and solid) was higher than that of patients without cancer. About one-third of the cancer patients surviving their hospital admission died within 1 year after ICU admission. We found a decrease in 1-year mortality until 2011 in hematology patients and no decrease in solid cancer patients. Our results suggest that for many cancer patients, an unplanned ICU admission is still a way to recover from critical illness, and it does not necessarily lead to success in long-term survival. The underlying type of malignancy is an important factor for long-term outcomes in patients recovering from critical illness.

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Section: Methodsmentioning

confidence: 99%

One-year Mortality of Cancer Patients with an Unplanned ICU Admission: A Cohort Analysis Between 2008 and 2017 in the Netherlands

Zee

Termorshuizen

Benoît

et al. 2021

J Intensive Care Med

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“…Several studies have been quoted to support a sex disparity in receiving bystander CPR during cardiac arrest (3,4). We agree that females received significantly less bystander CPR in out-of-hospital cardiac arrest (OHCA); however, only patients who survived to hospital discharge were enrolled in the current study (2), therefore the studied population already achieved ROSC and were different from all the OHCA patients.…”

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confidence: 73%

“…In the current study (2), the sex difference of prehospital ROSC may have resulted from the difference in age and arrest cause and seems unlikely to be caused by gender bias in treatment since all the enrolled patients received CPR. In Taiwan, the traditional culture discourages talking about death.…”

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confidence: 80%

“…The study by Tsai et al (1) demonstrated better neurologic recovery in men than women, attributing this to this influence of sex on prehospital return of spontaneous circulation (ROSC), which has rarely been reported in previous studies. Out-of-hospital cardiac arrest (OHCA) has a heavy influence on the disparity between men and women in determining neurologic recovery after ROSC (1, 2). Mody et al (3) found that due to a significantly higher proportion of women with do not resuscitate orders (35.7% vs 32.1%; p = 0.009) and premature withdrawal of life-sustaining treatment (32.8% vs 29.8%; p = 0.03), discharge survival was significantly lower in women (22.5% vs 36.3%; p < 0.001; adjusted odds ratio, 0.78 [95% CI, 0.66–0.93]; p = 0.005) among resuscitated OHCA patients.…”

Section: To the Editormentioning

confidence: 99%

“…The authors reply: T he letter by Honore et al (1) suggested that the late neurologic recovery in male sex in our recently published article (2) in Critical Care Medicine may be confounded by less prehospital return of spontaneous circulation (ROSC) and potentially less bystander cardiopulmonary resuscitation (CPR) in female cardiac arrest victims. Several studies have been quoted to support a sex disparity in receiving bystander CPR during cardiac arrest (3,4).…”

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confidence: 99%

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Neurologic Recovery in Men Versus Women Possibly Due to Reduced Return of Spontaneous Circulation: Beware of Potential Confounders!

Honoré

Redant

Djimafo

et al. 2022

Critical Care Medicine

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Do Women Have a Higher Mortality Risk Than Men following ICU Admission after Out-of-Hospital Cardiac Arrest? A Retrospective Cohort Analysis

Wees

Rietdijk

Mandigers

et al. 2021

JCM

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Purpose: previous studies showed that women have a higher mortality risk than men after out-of-hospital cardiac arrest (OHCA). This sex difference may disappear after adjustment for cardiac arrest characteristics. Most studies also included patients who were not admitted to the intensive care unit (ICU). We analyzed whether sex impacts the mortality of ICU-admitted OHCA patients. Methods: a retrospective cohort analysis of 1240 OHCA patients admitted to the ICU (310 women, 25%, AgeMedian 64.0 (IQR 53.8–73.0)) at an academic hospital in the Netherlands between 1 January 2007 and 31 December 2018. The primary outcome was 90-day mortality; the secondary outcome was a favorable cerebral performance category (CPC) score at ICU discharge and ICU length of stay (ICU LOS). Results: we found no association between sex and 90-day mortality (hazard ratio (HR) 0.867; 95% confidence interval (95% CI) 0.678–1.108) after adjusting for relevant cardiac arrest characteristics. Similarly, we found no difference for favorable CPC score (OR 1.117; 95% CI 0.777–1.608) or ICU LOS between sexes (Beta 0.428; 95% CI −0.442 to 1.298). Conclusions: after adjusting for cardiac arrest characteristics, we found no difference between women and men with respect to 90-day mortality, ICU LOS, and CPC score.

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Higher 1-year mortality in women admitted to intensive care units after cardiac arrest: A nationwide overview from the Netherlands between 2010 and 2018

Cited by 3 publications

References 39 publications

One-year Mortality of Cancer Patients with an Unplanned ICU Admission: A Cohort Analysis Between 2008 and 2017 in the Netherlands

One-year Mortality of Cancer Patients with an Unplanned ICU Admission: A Cohort Analysis Between 2008 and 2017 in the Netherlands

Neurologic Recovery in Men Versus Women Possibly Due to Reduced Return of Spontaneous Circulation: Beware of Potential Confounders!

Do Women Have a Higher Mortality Risk Than Men following ICU Admission after Out-of-Hospital Cardiac Arrest? A Retrospective Cohort Analysis

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