Abstract 258: Gender Difference and Outcome of Witnessed Patients With Out-of-Hospital Cardiac Arrest: Impact of the Administered ALS Procedures Before Hospital Arrival
Backgrounds: Recent studies revealed the impact of ALS programs to improve outcome for patients of out-of-hospital cardiac arrest (OHCA), but it is not certain whether there are gender differences for management and outcome.
Methods and Results: From January 1, 2005 to December 31, 2008, a prospective, population based, observational study was conducted nation-wide in Japan for patients who had OHCA and was attempted resuscitation by responders. There were 431,968 OHCA patients, and we focused on the patients with an arrest witnessed by a bystander, cardiac origin, and age 19 and older. The return of spontaneous circulation was the primary concern for this study. A total of 58,889 patients were included. Male patients were significantly younger and had VF or pulseless VT more frequently than female patients. Before hospital arrival, male patients tended to have more ALS procedures such as tracheal tube insertion, defibrillation, intravenous line insertion, and/or intravenous medication administration, and had better outcome than female patients. The relationship between the numbers of administered ALS procedures and the patients' outcome, the fewer administered group had the worse outcome, and the outcome difference between male and female was greater for more ALS procedures administrated groups.
Conclusions: Although there should be still many confounders to be adjusted, we found there were significant outcome differences between male and female OHCA patients, and the numbers of administered ALS procedures showed effect modification for the outcome. Our findings could be interpreted that there are still some room to improve OHCA patients' outcome for both gender.
- © 2010 by American Heart Association, Inc.