Abstract 18833: Out of Hospital Cardiac Arrest Outcomes and Resource Utilization in the United States: Do Females Fare Worse?
Background: For many disease entities, women have been shown to have worse outcomes compared to men. Although, the association of gender and out of hospital cardiac arrest (OHCA) outcomes has been investigated with conflicting results, no studies exist on a national basis in the United States. The goal of this investigation was to examine this phenomenon nationwide.
Methods: We used the 2002 to 2013 Nationwide Inpatient Sample database to identify adults ≥ 18 years with an ICD-9-CM principal diagnosis code of cardio respiratory arrest (427.5) or ventricular fibrillation (VF) (427.1). Patients admitted with trauma were excluded. Mortality rate, inflation-adjusted hospitalization costs, and length of hospital stay were estimated. Multiple linear and logistic regression models were conducted, and were adjusted for patient demographics, hospital characteristics and Charlson Comorbidity Index.
Results: From 2002 to 2013, of 154,177 patients hospitalized with OHCA, 62,962 (40.8%) were female, of which 37.0% survived to hospital discharge in contrast to 49.9% of males. Compared to males, females were older (66.9 vs. 65.8 yrs, p < 0.001), less likely to have VF as an initial rhythm (41.7% vs. 57.3%, p < 0.001), and less likely to undergo PCI (1.8% vs. 4.4%, p < 0.001). There was no difference in the prevalence of hypertension (52.8% vs 52.2%, p = 0.267) or diabetes mellitus (33.3% vs. 31.2%, p = 0.086) between females and males respectively. Survival was lower in females compared to males (AOR 0.85; 95% CI 0.81-0.91, p < 0.001). Although, prolonged hospitalization (>8 days) did not differ between genders (AOR 0.99; 95% CI 0.92-1.06, p = 0.748), hospitalization costs were significantly lower in females ($17,974 vs. $21,243, p < 0.001).
Conclusions: These national data confirm that despite similar comorbidities, females following non-traumatic out of hospital cardiac arrest, are more likely to die, and have a lesser utilization of health care dollars. Whether this observation is causal or casual is unknown, but warrants in-depth examination.
Author Disclosures: B. Akinyele: None. S. Eid: None. L. Raghavakurup: None. N. Chandra-Strobos: None. A. Albaeni: None.
- © 2016 by American Heart Association, Inc.