Abstract 335: Gender Disparities in the Use of Therapeutic Hypothermia After Cardiac Arrest: An Analysis From the Penn Alliance for Therapeutic Hypothermia (PATH) Registry
Background: Recent studies have shown that gender disparities exist in cardiac arrest outcomes and are thought to be multifactorial. Gender disparities in the use of therapeutic hypothermia have not been fully investigated and may contribute to disparities in survival and neurologic recovery after cardiac arrest.
Objectives: We examined gender disparities in cardiac arrest care in a multi-center registry of post-arrest patients.
Methods: The Penn Alliance for Therapeutic Hypothermia (PATH) Registry contains data from 18 hospitals nationwide. Patients are >18 years of age, suffered either an in-hospital (IHCA) or out-of-hospital (OHCA) cardiac arrest, and presented to one of the enrolling centers. Demographic and arrest characteristics were analyzed with descriptive statistics, and gender comparisons were made for age, initial rhythm, bystander CPR, return of spontaneous circulation (ROSC), use of therapeutic hypothermia (TH) and neurologic outcome (cerebral performance category (CPC)).
Results: The PATH registry contained 1,767 eligible patients who suffered a cardiac arrest between 5/1/2005 and 4/30/2013. In total, 666 (42%) were female and mean age of women was 65.4 ± 18.1 years vs. men who were 62.3 ± 16.6 years (p<0.001). There was no gender difference in the proportion of patients who suffered OHCA (1270) vs. IHCA (497). Of patients who suffered an out-of-hospital cardiac arrest, 40% of men versus 34% of women received by-stander CPR (p=0.07). Women had a higher proportion of non-shockable rhythms (80% vs. 72%; p <0.001), however, there was no difference in rate of ROSC (54% vs. 51%; p=0.11). Female patients who remained comatose after ROSC received TH less often then their male counterparts (56% vs. 62%; p=0.06), and demonstrated worse neurological outcomes at hospital discharge (CPC 1 or 2: 16% vs. 20%; p=0.03).
Conclusion: Female patients were older, more likely to have non-shockable rhythms, and less likely to get by-stander CPR. There is disparity in the use of TH in female patients, with a trend towards more men receiving TH. Consequently, women have significantly worse rates of neurologic recovery then male victims of cardiac arrest. Future identification of the component factors responsible for this disparity may be amenable to change.
- © 2013 by American Heart Association, Inc.