There is a difference in characteristics and outcome between women and men who suffer out of hospital cardiac arrest
Introduction
The majority of deaths due to ischaemic heart disease occur outside hospital, mainly due to ventricular fibrillation [1]. An increasing proportion of such patients can be successfully resuscitated and survive until hospital discharge [2].
During the last decade there has been a debate as to whether men and women differ in characteristics and outcome when suffering from an acute coronary syndrome [3], [4]. However, few studies have evaluated whether there is a gender difference in characteristics and outcome after out of hospital cardiac arrest.
This survey describes the relation of various factors in resuscitation and survival to gender among consecutive patients suffering out of hospital cardiac arrest with attempted CPR in the community of Göteborg over a period of 16 years.
Section snippets
Target area and population
The city of Göteborg, covering an area of 449 km2, has 434 000 inhabitants, of whom 48% are male. The classification of age groups in 1990 was as follows: 0–12 months 1%; 1–4 years 5%; 5–14 years 10%; 15–24 years 13%; 25–34 years 17%; 35–44 years 14%; 45–54 years 12%; 55–64 years 9%; 65–74 years 10%; 75–84 years 7%; >85 years 2%.
In Göteborg 9% of the population are below the official poverty level, i.e. require financial support from the community. Of the total population, 65% continue their
Results
In all there were 4453 out of hospital cardiac arrests in which CPR was attempted during the study period. Information on gender was not computerized in 52 cases (1%). This study deals with the remaining 4401 cases. Of these 28% were women.
Discussion
This study has the advantage of including all patients who suffered out of hospital cardiac arrest who had attempted resuscitation efforts in a well-defined area over a period of 16 years.
Coronary heart disease is one of the leading causes of death in women in developed countries [7], [8]. The development of and mortality from coronary heart disease occur about 10 years later in women than in men [9], [10]. This explains why only 28% of our study population were women and that women were
Conclusion
Among patients who suffer out of hospital cardiac arrest with attempted CPR, women differ from men in being older, receiving bystander CPR less frequently, having cardiac aetiology of the arrest less frequently and being found in ventricular fibrillation less often. Female gender is an independent predictor for patients being hospitalized alive.
References (25)
- et al.
Survival after cardiac arrest outside hospital over a 12-year period in Gothenburg
Resuscitation
(1994) - et al.
Patterns of coronary heart disease morbidity and mortality in the sexes: a 26 year follow-up of the Framingham population
Am Heart J
(1986) - et al.
Survival of out-of-hospital cardiac arrest with early initiation of cardiopulmonary resuscitation
Am J Emerg Med
(1985) - et al.
The effect of bystander CPR on survival of out-of-hospital cardiac arrest victims
Am Heart J
(1985) - et al.
Predicting survival from out-of-hospital cardiac arrest: a multivariate analysis
Resuscitation
(1997) - et al.
Gender difference in autonomic and hemodynamic reactions to abrupt coronary occlusion
J Am Coll Cardiol
(1998) - et al.
Resuscitation from out-of-hospital ventricular fibrillation 4 years follow-up
Circulation
(1975) - et al.
Effect of gender on long-term outcome of angina pectoris and myocardial infarction/sudden unexpected death
J Am Med Assoc
(1993) - et al.
Sex differences in case fatality before and after admission to hospital after acute cardiac events: analysis of community based coronary heart disease register
Brit Med J
(1996) - et al.
Death outside hospital with special reference to heart disease
Eur Heart J
(1984)
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Sex differences in post cardiac arrest discharge locations
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2021, ResuscitationCitation Excerpt :Despite improvements in pre-hospital and hospital care, many factors have still been found to be linked to worse outcomes, including female sex.4–9 The majority of OHCA patients are men,1,4–5,10–11 yet women present with worse prognostic factors including older age,8,12–15 more unwitnessed arrests,10,12–14,16 fewer initial shockable rhythms,5,8,10,13–17 fewer presumed cardiac causes for their arrest,11–12,15 and receipt of less bystander CPR.12,17 Despite these differences, studies have reported mixed results with regard to the association between female sex and outcome, with some showing lower survival4–7 and worse neurologic outcomes6,8–9 among women while others show equal or improved outcomes following adjusted analyses.8,10,12–13,15–19
The influence of age and gender on delay to treatment and its association with survival after out of hospital cardiac arrest
2021, American Journal of Emergency MedicineGender differences in utilization of coronary angiography and angiographic findings after out-of-hospital cardiac arrest: A registry study
2019, ResuscitationCitation Excerpt :Women have lower rates of a shockable first ECG rhythm (VF/VT), which may be viewed as an indicator of cardiac aetiology. Among patients with a shockable first rhythm, female gender is even associated with good long-term outcome16 which is not seen in studies of OHCA victims irrespective of first rhythm.14,22,23 It is important to identify which patients to refer for early CAG after OHCA, i.e. to find those who will probably benefit from treatment with PCI but also to identify those who will not benefit.