Abstract P146: Beneficial Effects of Female Gender on Survival From Sudden Cardiac Arrest
Introduction: Women with sudden cardiac arrest (SCA) are more likely to be found at home and to manifest with pulseless electrical activity (PEA). Since both factors have a negative impact on survival, we evaluated the effects of gender, presenting arrhythmia and location of SCA on outcome from sudden cardiac arrest (SCA).
Methods: Cases of SCA were identified from an ongoing prospective, multiple-source prospective evaluation of a one million population of residents of the northwest US. Subjects included were age ≥18 yrs who underwent attempted resuscitation by EMS providers. Pearson’s chi-square tests and independent samples t-tests were used for gender comparisons. We evaluated gender differences in survival adjusted for age and the circumstances of arrest using a logistic regression model predicting survival.
Results: A total of 1277 cases (852 men, 425 women) had resuscitation attempted (2002–2007). Women were older than men (68±16 vs. 63±15 yrs, p<0.0001) and were more likely to have return of spontaneous circulation (41% vs. 33%, p=0.004). Women were more likely to have PEA and asystole as a presenting rhythm, whereas VF/VT were more common among men (p<0.0001). There were no significant gender differences in survival to hospital discharge (p=0.23). However, when stratified by presenting arrhythmia, women were more likely than men to survive to hospital discharge whether they presented with VF/VT (30.3% vs. 20.4% survival, p=0.05), or PEA (11.5% vs. 2.6% survival, p=0.003). Of the 63 female survivors, 23.0% had presented with PEA, while 5.4% of male survivors presented with PEA (p=0.002). In a multivariate model adjusting for age, presenting arrhythmia, arrest circumstances and arrest location, women were more likely than men to survive to hospital discharge [OR 1.56; 95% CI (1.05–2.32)].
Conclusions: Despite older age, higher prevalence of SCA in the home and higher rates of PEA, women have a survival advantage from sudden cardiac arrest that warrants further detailed study.