Abstract 30: Women with a Bad Prognosis After Return of Spontaneous Circulation After Out-of Hospital Cardiac Arrest: A Retrospective Study in 1 Emergency Center
Introduction: Several studies were reported that women in child-bearing period have a good prognosis than men in hypoxic brain damage, traumatic brain injury and so on. That is, hormones like progesterone and estrogen have a neuroprotective effect and these are abundant in young women. The aim of this study was to analyze the gender factors associated with good or bad prognosis after return of spontaneous circulation after out-of hospital cardiac arrest
Methods: The patients admitted to the intensive care unit after successful resuscitation after out-of hospital cardiac arrest were retrospectively identified and evaluated. Basal characteristic of the patients including factors associated with social history, basic life support and advanced cardiovascular life support were analyzed. Ninety days mortality after admission and neurologic outcome (cerebral performance category[CPC]) were evaluated.
Result: One hundred forty-two patients were evaluated in this study; there were 101 males (71.1%). The median age was 52 years old (43-63). Ninety days after admission, 85 patients (59.9%) survived. 40 patients had a good neurologic outcome (CPC 1-2). The factors associated 90 days mortality were cause of death (non-cardiac, p=0.03), lactate in emergency department (p=0.05) and the factors associated with good neurologic outcome were males (p=0.007), young age (p=0.01), body weight and height (p=0.001), cause of death (cardiac, p=0.000), witnessed arrest(p=0.012). Alcohols and smoking were not associated with mortality and neurologic outcome. In multivariable logistic regression analysis, the patients in women had a 8-fold increased risk(odds ratio [OR] 8.038, 95% Confidence Interval [CI] 1.079-59.903) to poor neurologic outcome(CPC 3-5). Other factors associated with poor neurologic outcome were non-cardiac cause of death (OR 5.523, 95% CI 1.562-19.533) and old age (over 65 years old, OR 1.055, 95% CI 1.009-1.103).
Conclusion: Women had a poor neurologic outcome after return of spontaneous circulation after out-of hospital cardiac arrest in one emergency center. Known gender-related neuroprotective hormonal factors might not be associated this gender differences. Other additional factors should be evaluated.
- © 2011 by American Heart Association, Inc.