Abstract 61: Effect of Gender on Outcome of Out of Hospital Cardiac Arrest in the Resuscitation Outcomes Consortium
Introduction: Over the last two decades many studies have reported that certain medical conditions/diseases have innate gender-based predominance due to specific hormonal regulation. Women are likely to have unfavorable outcomes in cardiac arrest with significantly lower unadjusted survival rates than men This study examined the relationship between gender and outcome of non-traumatic out of hospital cardiac arrest (OHCA).
Hypothesis: Gender is associated with the outcome of non-traumatic OHCA.
Methods: All non-traumatic EMS treated OHCA patients in the Resuscitation Outcomes Consortium between December 2005 and May 2007 prior to launching of ROC PRIMED RCT were included. Patient age was analyzed as a continuous variable. To further separate the groups by hormonal status patients were stratified in the two age cohorts: 15–45 and >55 years of age (yo). Unadjusted chi square tests and logistic regression models were employed to examine the relationship between gender, age and survival outcomes.
Results: This study enrolled 14633 patients; 63.6% were male with a mean age of 64.2 and 36.4% were female with a mean age of 68.3. Women survived to hospital discharge less often then men (6.4% vs. 9.1%, p<0.001); the unadjusted OR for gender and outcome was 0.69, 95%CI: 0.60, 0.77. In models adjusting for all Utstein predictors difference in survival rates between the genders did not reach statistical significance (p=0.07, OR: 0.86 95%CI: 0.73, 1.01). The unadjusted survival rate for younger women (15–45yo) was 11.1% vs. 9.8% for younger men (p=0.52, OR: 1.15, 95%CI: 0.81, 1.62). In contrast the unadjusted survival rate for older women (>55yo) was lower compared to men (5.5% vs. 8.4%, p<0.001, OR: 0.63, 95%CI: 0.58, 0.6). When the Utstein predictors were included in the model, women survived more often then men in the 15–45 cohort (p=0.03, OR: 1.66, 95%CI: 1.04, 2.64) but no difference in discharge rates was observed in the >55 cohort (p=0.57, OR: 0.94, 95%CI: 0.78, 1.15).
Conclusions: Survival rates to hospital discharge of OHCA differ between men and women, but this difference appears to be confounded by several Utstein factors. Age modifies the association of gender; a result that supports a protective hormonal effect among premenopausal women.
- © 2010 by American Heart Association, Inc.