Gender differences in short- and long-term outcome after out-of-hospital cardiac arrest. Analysis of the LINC trial.
(English)Manuscript (preprint) (Other academic)
Background: We aimed to identify gender differences in survival after out-of-hospital cardiac arrest (OHCA).
Methods: 2,589 OHCA victims were analyzed, 33.3% women, from the LINC trial. After identifying gender differences in baseline characteristics, cardiac arrest (CA) events and survival rates, multivariable logistic regression was performed irrespective of treatment group.
Results: Unadjusted analysis demonstrated no difference between women and men in 4- hour survival, 22.1% vs. 24.4% (p=0.20). Women had lower survival rates at hospital discharge, 6.7% vs. 10.1% (p=0.003) and after 6 months, 5.9% vs. 9.5% (p=0.002). Women were older, 71.5 vs. 67.9 years of age (p<0.001), had lower rates of CA with suspected cardiac aetiology, 63.8% vs. 74.3% (p<0.001), and shockable first rhythm, 18.9% vs. 35.0% (p<0.001). More women had crew-witnessed CA, 9.3% vs. 6.0% (p=0.002). There was no difference regarding witnessed CA, 65.3% vs. 67.2% (p=0.33) and bystander CPR, 55.2% vs. 57.7% (p=0.24).
After adjusting for age, randomization group, witnessed CA, bystander CPR, first analysed rhythm and cardiac aetiology, female gender was an independent predictor for 4-hour survival, OR 1.34 (95% C.I. 1.06 – 1.69) but not for survival at hospital discharge, OR 1.19 (95% C.I. 0.83 – 1.72) or after 6 months, OR 1.12 (95% C.I. 0.76 – 1.63).
Fewer women were treated with coronary angiography, percutaneous coronary intervention and therapeutic hypothermia, 23.5% vs. 45.7% (p<0.001), 14.5% vs. 30.2% (p<0.001), 54.0% vs. 69.1% (p<0.001), respectively.
Conclusions: Female gender was an independent predictor for early survival. At hospital discharge and after 6 months these gender differences in survival were no longer found.
Cardiac arrest, gender differences, out-of-hospital cardiac arrest, randomized controlled trial, mechanical chest compression, defibrillation, LUCAS CPR, external chest compressions, ventricular fibrillation, systole, pulseless electrical activity.
Medical and Health Sciences
Research subject Anaesthesiology and Intensive Care
IdentifiersURN: urn:nbn:se:uu:diva-303993OAI: oai:DiVA.org:uu-303993DiVA: diva2:975069