Abstract 56: Gender Difference in Treatment Options and Outcomes in Patients With Out of Hospital Cardiac Arrest
Objective: we aimed to investigate the gender difference in treatments and outcomes of out of hospital cardiac arrest (OHCA) victims.
Methods: A nationwide OHCA database (2006–2007) (the CAVAS project) was developed based on EMS registry, which was constructed from ambulance run sheet and followed by medical record review. The essential elements of the database were based on the Utstein style. Included factors are social and demographic data, call time, hospital arrival time, existence of witness, utilization of automated external defibrillators (AED), providence of prehospital cardiopulmonary resuscitation (CPR) as well as inhospital CPR. Outcome value as survival to discharge and cerebral performance category (CPC) was also collected. We selected cases with suspected cardiac origin for the analysis. We did univariate analysis to determine the effect of gender on the treatment. After that, a multivariate analysis was carried out to determine the effect of gender on the application of AED and outcomes. Age group, presence of witness, EMS response time, and transport time was adjusted.
Results: Overall, total OHCA with presumed cardiac origin were 19,045. 12,111 (63.6%) of these were male. The mean age was 58.02 (± 19.01) year for male group, and 65.57 (± 21.48) for the female group (p <0.0001). The percentage of witness arrest was 44.26% and 41.48% respectively (p<0.0001). The presence of shockable rhythm was 5.29% and 2.80% (p<0.0001). The male group showed higher rate of receiving prehospital CPR (75.82% vs 68.37%) (p<0.0001), higher rate of having AED attached (10.85% vs 7.5%) (p<0.0001), and higher rate or receiving inhospital CPR (46.59% vs 38.17%) (p<0.0001). Consequently, the rate of survival to discharge was higher for the male group (3.24% vs 1.89%) (p<0.0001) and the rate of good CPC was also higher for the male group (1.14% vs 0.50%) (<0.0001) The multivariate logistic regression showed lower ratio of applying AED in the female group (OR 0.781, 0.699∼0.087), while other outcomes were not associated with gender difference.
Conclusion: Male OHCAs tend to receive more treatments than female, which resulted in better outcome. After adjusting potential factors, the gender still influenced the usage of AED.
- © 2010 by American Heart Association, Inc.