Abstract 117: Gender Differences in Outcome After Out-of-Hospital Cardiac Arrest: Analysis of the LINC Trial
BACKGROUND: Despite several factors associated with poor outcome after out-of-hospital cardiac arrests (OHCA), female gender is considered to be an independent predictor of survival after OHCA. Nevertheless, several register based studies have shown worse long term outcome for women after OHCA.
AIM: To identify gender differences in survival after OHCA.
METHODS: An analysis of 2589 OHCA victims, with 33.3% women, previously included in a multicenter randomized trial, the LINC trial. After identifying gender differences in baseline characteristics, cardiac arrest (CA) events and survival rates, multivariable logistic regression was performed. In this analysis of gender, both treatment arms with manual and mechanical CPR was grouped together.
RESULTS: In our unadjusted analysis there were no difference between women and men in 4-hour survival, 22.1 vs 24.4% (P=0.202). Women had lower survival rate at hospital discharge, 6.7 vs 10.1% (P=0.003) and after 6 months, 5.9 vs 9.5% (P=0.002).
Women were older, 71.5 vs 67.9 years old (P<0.000), had lower rates of CA with suspected cardiac etiology, 56.4 vs 67.4% (P<0.000), and shockable first rhythm, 18.5 vs 34.6% (P<0.000). More women had crew witnessed CA, 9.3 vs 6.0% (P=0.001). There was no difference regarding witnessed CA, 64.2 vs 66.5% (P=0.327) and bystander CPR, 54.3 vs 57.1% (P=0.243).
After adjusting for age, randomization group, witnessed CA, bystander CPR, first analyzed rhythm and cardiac etiology underlying the CA, female gender were found to be an independent predictor for 4-hour survival, OR 1.34 (95% C.I. 1.06 - 1.69) but not for survival at hospital discharge, OR 1.19 (95% C.I. 0.83 - 1.72) or after 6 months, OR 1.12 (95% C.I. 0.76 - 1.63).
CONCLUSIONS: Female gender was found to be an independent predictor for early survival. However, at hospital discharge and after 6 months these gender differences in survival were no longer found. Further studies are needed to explore the mechanisms behind these disparities.
Author Disclosures: E. Lindgren: None. O. Östlund: None. S. Rubertsson: None.
- © 2014 by American Heart Association, Inc.