Influence of sex on survival, neurologic outcomes, and neurodiagnostic testing after out-of-hospital cardiac arrest
Autor: | Niklas Nielsen, Sachin Agarwal, David B. Seder, Robert Hand, Wei Xiong, Pascal Stammet, Richard R. Riker, Nainesh Patel, Michael Mlynash, Hans Friberg, Karen G. Hirsch, Tobias Cronberg, Michael Mooney, Allison Dupont, Josef Dankiewicz, Andrea O'Riordan, Teresa May, Eldar Søreide, John A. McPherson, Melissa A. Vogelsong |
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Rok vydání: | 2021 |
Předmět: |
Emergency Medical Services
medicine.medical_specialty business.industry Emergency Nursing Cardiopulmonary Resuscitation Out of hospital cardiac arrest Internal medicine Baseline characteristics Intensive care Emergency Medicine medicine Hospital discharge Bystander cpr Humans Female Prospective Studies Registries Cardiology and Cardiovascular Medicine business Out-of-Hospital Cardiac Arrest Retrospective Studies |
Zdroj: | Resuscitation. 167:66-75 |
ISSN: | 0300-9572 |
DOI: | 10.1016/j.resuscitation.2021.07.037 |
Popis: | Aim Previous studies evaluating the relationship between sex and post-resuscitation care and outcomes following out-of-hospital cardiac arrest (OHCA) are conflicting. We investigated the association between sex and outcomes as well as neurodiagnostic testing in a prospective multicenter international registry of patients admitted to intensive care units following OHCA. Methods OHCA survivors enrolled in the International Cardiac Arrest Registry (INTCAR) from 2012 to 2017 were included. We assessed the independent association between sex and survival to hospital discharge, good neurologic outcome (Cerebral Performance Category 1 or 2), neurodiagnostic testing, and withdrawal of life-sustaining therapy (WLST). Results Of 2407 eligible patients, 809 (33.6%) were women. Baseline characteristics differed by sex, with less bystander CPR and initial shockable rhythms among women. Women were less likely to survive to hospital discharge, however significance abated following adjusted analysis (30.1% vs 42.7%, adjusted OR 0.85, 95% CI 0.67–1.08). Women were less likely to have good neurologic outcome at discharge (21.4% vs 34.0%, adjusted OR 0.74, 95% CI 0.57–0.96) and at six months post-arrest (16.7% vs 29.4%, adjusted OR 0.73, 95% CI 0.54–0.98) that persisted after adjustment. Neuroimaging (75.5% vs 74.3%, p = 0.54) and other neurophysiologic testing (78.8% vs 78.6%, p = 0.91) was similar across sex. Women were more likely to undergo WLST (55.6% vs 42.8%, adjusted OR 1.35, 95% CI 1.09–1.66). Conclusions Women with cardiac arrest have lower odds of good neurologic outcomes and higher odds of WLST, despite comparable rates of neurodiagnostic testing and after controlling for baseline differences in clinical characteristics and cardiac arrest features. |
Databáze: | OpenAIRE |
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