Elsevier

Resuscitation

Volume 40, Issue 3, May 1999, Pages 133-140
Resuscitation

There is a difference in characteristics and outcome between women and men who suffer out of hospital cardiac arrest

https://doi.org/10.1016/S0300-9572(99)00022-2Get rights and content

Abstract

Objective: To evaluate whether there is a difference in characteristics and outcome in relation to gender among patients who suffer out of hospital cardiac arrest. Design: Observational study. Setting: The community of Göteborg. Patients: All patients in the community of Göteborg who suffered out of hospital cardiac arrest between 1980 and 1996, and in whom cardiopulmonary resuscitation (CPR) was initiated. Main outcome measures: Factors at resuscitation and the proportion of patients being hospitalized and discharged from hospital. P values were corrected for age. Results: The women were older than the men (median of 73 vs. 69 years; P<0.0001), they received bystander-CPR less frequently (11 vs. 15%; P=0.003), they were found in ongoing ventricular fibrillation less frequently (28 vs. 44%; P<0.0001), and their arrests were judged to be of cardiac origin less frequently. In a multivariate analysis considering age, gender, arrest being due to a cardiac etiology, initial arrhythmia and by-stander initiated CPR, female gender appeared as an independent predictor for patients being brought to hospital alive (odds ratio 1.37; P=0.001) but not for patients being discharged from hospital. Conclusion: Among patients who suffer out of hospital cardiac arrest with attempted CPR women differ from men being older, receive bystander CPR less frequently, have a cardiac etiology less frequently and are found in ventricular fibrillation less frequently. Finally female gender is associated with an increased chance of arriving at hospital alive.

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)

  • D.G. Atlman
  • World Health Organization. Statistics Annual, 1989. Geneva:...
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