Increase in survival and bystander CPR in out-of-hospital shockable arrhythmia: bystander CPR and female gender are predictors of improved outcome. Experiences from Sweden in an 18-year perspective

Abstract

Objectives In a national perspective, to describe survival among patients found in ventricular fibrillation or pulseless ventricular tachycardia witnessed by a bystander and with a presumed cardiac aetiology and answer two principal questions: (1) what are the changes over time? and (2) which are the factors of importance? Design Observational register study.

Differential Survival for Men and Women from Out-of-hospital Cardiac Arrest Varies by Age: Results from the OPALS Study

“…In contrast to other studies, 18,25 we found that women had lower survival compared to men when cardiac arrests were witnessed. After stratifying by sex, we found that survival for women improved in phase 3 compared to phase 2 of the OPALS study (following ACLS implementation).…”

“…A majority show either no survival advantage 9,[12][13][14][15][16][17][18] or higher survival in men, 8,10,[19][20][21][22][23][24] while others indicate that women fare better. 18,25,26 Studies that report worse survival in women often attribute it to worse prehospital factors. Women are less likely to have witnessed arrests, bystander CPR, EMS CPR, and intravenous (IV) medications.…”

“…11,27 There is also controversy with respect to survival advantage for women for shockable or other rhythms. 28,29 Six studies to date have evaluated the age-sex interaction. Four show a survival advantage in younger women.…”

Sex Differences in Survival From Out‐of‐Hospital Cardiac Arrest in the Era of Regionalized Systems and Advanced Post‐Resuscitation Care

“…9,14,17,18 Several population studies have continued to find a survival advantage to female sex within strata of shockable and/or nonshockable rhythm; however, these studies have not reported frequency of interventions in postresuscitation care. 19,20 Changes in resuscitation care may differentially affect men and women. In LA County, advanced postresuscitation care capabilities, including PCI and TTM, are required at the cardiac arrest receiving centers.…”

Changes in pre‐ and in‐hospital management and outcomes for out‐of‐hospital cardiac arrest between 2002 and 2012 in Kanto, Japan: the SOS‐KANTO 2012 Study

“…4 However, the past 10 years have witnessed the advancement of OHCA studies using large data, which have shown drastic improvement in OHCA survival rates in locations globally, including the USA, 5 Europe, 6,7 and Asia. [8][9][10][11] Large-scale studies have suggested that two factors are key to achieving improvement: bystanders' actions in prehospital settings, 3,[6][7][8][9]12,13 and postresuscitation care following hospital arrival. 5,10,14 However, the majority of the evidence presented in these studies was derived from either pre-or in-hospital databases.…”