Clinical paperEffect of gender on outcome of out of hospital cardiac arrest in the Resuscitation Outcomes Consortium
Section snippets
Background
The median incidence of cardiac arrest treated by Emergency Medical Services (EMS), across the sites participating in the Resuscitation Outcomes Consortium (ROC) is 52 per 100,000 population.1 Survival-to-hospital discharge rates after out-of-hospital cardiac arrest (OHCA) vary. In 2008, the survival-to-discharge rates across the ROC sites varied from 3.0% to 16.3%.1
Certain medical conditions/diseases have gender1
Design
The Resuscitation Outcomes Consortium (ROC) Epistry-Cardiac Arrest registry is a prospective, population-based, multicentre, North American cohort study of non-traumatic OHCA.38, 39 The ROC Epistry Study met the requirements for minimal risk research in the United States40 and Canada41, and was approved for waiver of informed consent by 161 institutional research ethics boards.
Setting
ROC is a North American network of 10 US and Canadian sites that investigate OHCA (Fig. 1). ROC has one data
Results
This study of 14,690 consecutive patients treated by EMS included 5340 (36.4%) women with a mean age of 68.3 and 9350 (63.6%) men with a mean age of 64.2. (Fig. 1 and Table 1) The unadjusted incidence rate of treated OHCA for women ranged from 34 to 104 per 100,000 person years (median 41) across ROC sites while for men it ranged from 64 to 123 per 100,000 person years (median 85).
Event characteristics are displayed in Table 1. Many of the Utstein predictors of survival are more likely to be
Discussion
Data from a prospective, North American multisite population-based database of OHCA patients attended by participating EMS agencies suggests that women who suffer an OHCA are less likely to experience event characteristics associated with survival and less likely to survive. When survival is adjusted for this imbalance in predictors of outcome, women are more likely to obtain a ROSC in the prehospital setting but the gender difference in survival to discharge disappears. However, in women
Conclusion
Women who suffer an OHCA are less likely to have Utstein event characteristics associated with survival such as arresting in a public location or an initial shockable rhythm or bystander resuscitation and have a lower rate of survival to discharge. After adjusting for the imbalance in these predictors, there was no observed gender difference in survival. As in other studies, women in the 15–45 year old cohort had a higher survival rate than men, a protective hormonal effect among premenopausal
Conflict of interest statement
All Authors have no conflict of interest with any financial and personal relationships with other people or organizations that could inappropriately influence (bias) their work.
Acknowledgements
The ROC is supported by a series of cooperative agreements to 10 regional clinical centres and one Data Coordinating Centre (5U01 HL077863—University of Washington Data Coordinating Centre, HL077865—University of Iowa, HL077866—Medical College of Wisconsin, HL077867—University of Washington, HL077871—University of Pittsburgh, HL077872—St. Michael's Hospital, HL077873—Oregon Health and Science University, HL077881—University of Alabama at Birmingham, HL077885—Ottawa Hospital Research Institute,
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