Survival after out-of-hospital cardiac arrest in relation to sex: A nationwide registry-based study

Mads Wissenberg; Carolina Malta Hansen; Fredrik Folke; Freddy K Lippert; Peter Weeke; Lena Karlsson; Shahzleen Rajan; Kathrine Bach Søndergaard; Kristian Kragholm; Erika Frischknecht Christensen; Søren L Nielsen; Lars Køber; Gunnar H Gislason; Christian Torp-Pedersen

doi:10.1016/j.resuscitation.2014.06.008

Survival after out-of-hospital cardiac arrest in relation to sex: A nationwide registry-based study

Mads Wissenberg, Carolina Malta Hansen, Fredrik Folke, Freddy K Lippert, Peter Weeke, Lena Karlsson, Shahzleen Rajan, Kathrine Bach Søndergaard, Kristian Kragholm, Erika Frischknecht Christensen, Søren L Nielsen, Lars Køber, Gunnar H Gislason, Christian Torp-Pedersen

Institut for Klinisk Medicin

48 Citationer (Scopus)

Abstract

Aim: Crude survival has increased following an out-of-hospital cardiac arrest (OHCA). We aimed to study sex-related differences in patient characteristics and survival during a 10-year study period. Methods: Patients ≥12 years old with OHCA of a presumed cardiac cause, and in whom resuscitation was attempted, were identified through the Danish Cardiac Arrest Registry 2001-2010. A total of 19,372 patients were included. Results: One-third were female, with a median age of 75 years (IQR 65-83). Compared to females, males were five years younger; and less likely to have severe comorbidities, e.g., chronic obstructive pulmonary disease (12.8% vs. 16.5%); but more likely to have arrest outside of the home (29.4% vs. 18.7%), receive bystander CPR (32.9% vs. 25.9%), and have a shockable rhythm (32.6% vs. 17.2%), all p<. 0.001. Thirty-day crude survival increased in males (3.0% in 2001 to 12.9% in 2010); and in females (4.8% in 2001 to 6.7% in 2010), p<. 0.001.Multivariable logistic regression analyses adjusted for patient characteristics including comorbidities, showed no survival difference between sexes in patients with a non-shockable rhythm (OR 1.00; CI 0.72-1.40), while female sex was positively associated with survival in patients with a shockable rhythm (OR 1.31; CI 1.07-1.59). Analyses were rhythm-stratified due to interaction between sex and heart rhythm; there was no interaction between sex and calendar-year. Conclusions: Temporal increase in crude survival was more marked in males due to poorer prognostic characteristics in females with a lower proportion of shockable rhythm. In an adjusted model, female sex was positively associated with survival in patients with a shockable rhythm.

Originalsprog	Engelsk
Tidsskrift	Resuscitation
Vol/bind	85
Udgave nummer	9
Sider (fra-til)	1212–1218
Antal sider	7
ISSN	0300-9572
DOI	https://doi.org/10.1016/j.resuscitation.2014.06.008
Status	Udgivet - sep. 2014

Adgang til dokumentet

10.1016/j.resuscitation.2014.06.008

Citationsformater

Wissenberg, M., Hansen, C. M., Folke, F., Lippert, F. K., Weeke, P., Karlsson, L., Rajan, S., Søndergaard, K. B., Kragholm, K., Christensen, E. F., Nielsen, S. L., Køber, L., Gislason, G. H., & Torp-Pedersen, C. (2014). Survival after out-of-hospital cardiac arrest in relation to sex: A nationwide registry-based study. Resuscitation, 85(9), 1212–1218. https://doi.org/10.1016/j.resuscitation.2014.06.008

Wissenberg, M, Hansen, CM, Folke, F, Lippert, FK, Weeke, P, Karlsson, L, Rajan, S, Søndergaard, KB, Kragholm, K, Christensen, EF, Nielsen, SL, Køber, L, Gislason, GH & Torp-Pedersen, C 2014, 'Survival after out-of-hospital cardiac arrest in relation to sex: A nationwide registry-based study', Resuscitation, bind 85, nr. 9, s. 1212–1218. https://doi.org/10.1016/j.resuscitation.2014.06.008

@article{82d2ba1b50ea4b5793bfbd209c2ad831,

title = "Survival after out-of-hospital cardiac arrest in relation to sex: A nationwide registry-based study",

abstract = "Aim: Crude survival has increased following an out-of-hospital cardiac arrest (OHCA). We aimed to study sex-related differences in patient characteristics and survival during a 10-year study period. Methods: Patients ≥12 years old with OHCA of a presumed cardiac cause, and in whom resuscitation was attempted, were identified through the Danish Cardiac Arrest Registry 2001-2010. A total of 19,372 patients were included. Results: One-third were female, with a median age of 75 years (IQR 65-83). Compared to females, males were five years younger; and less likely to have severe comorbidities, e.g., chronic obstructive pulmonary disease (12.8% vs. 16.5%); but more likely to have arrest outside of the home (29.4% vs. 18.7%), receive bystander CPR (32.9% vs. 25.9%), and have a shockable rhythm (32.6% vs. 17.2%), all p<. 0.001. Thirty-day crude survival increased in males (3.0% in 2001 to 12.9% in 2010); and in females (4.8% in 2001 to 6.7% in 2010), p<. 0.001.Multivariable logistic regression analyses adjusted for patient characteristics including comorbidities, showed no survival difference between sexes in patients with a non-shockable rhythm (OR 1.00; CI 0.72-1.40), while female sex was positively associated with survival in patients with a shockable rhythm (OR 1.31; CI 1.07-1.59). Analyses were rhythm-stratified due to interaction between sex and heart rhythm; there was no interaction between sex and calendar-year. Conclusions: Temporal increase in crude survival was more marked in males due to poorer prognostic characteristics in females with a lower proportion of shockable rhythm. In an adjusted model, female sex was positively associated with survival in patients with a shockable rhythm.",

author = "Mads Wissenberg and Hansen, {Carolina Malta} and Fredrik Folke and Lippert, {Freddy K} and Peter Weeke and Lena Karlsson and Shahzleen Rajan and S{\o}ndergaard, {Kathrine Bach} and Kristian Kragholm and Christensen, {Erika Frischknecht} and Nielsen, {S{\o}ren L} and Lars K{\o}ber and Gislason, {Gunnar H} and Christian Torp-Pedersen",

year = "2014",

month = sep,

doi = "10.1016/j.resuscitation.2014.06.008",

language = "English",

volume = "85",

pages = "1212–1218",

journal = "Resuscitation",

issn = "0300-9572",

publisher = "Elsevier Ireland Ltd",

number = "9",

}

TY - JOUR

T1 - Survival after out-of-hospital cardiac arrest in relation to sex

T2 - A nationwide registry-based study

AU - Wissenberg, Mads

AU - Hansen, Carolina Malta

AU - Folke, Fredrik

AU - Lippert, Freddy K

AU - Weeke, Peter

AU - Karlsson, Lena

AU - Rajan, Shahzleen

AU - Søndergaard, Kathrine Bach

AU - Kragholm, Kristian

AU - Christensen, Erika Frischknecht

AU - Nielsen, Søren L

AU - Køber, Lars

AU - Gislason, Gunnar H

AU - Torp-Pedersen, Christian

PY - 2014/9

Y1 - 2014/9

N2 - Aim: Crude survival has increased following an out-of-hospital cardiac arrest (OHCA). We aimed to study sex-related differences in patient characteristics and survival during a 10-year study period. Methods: Patients ≥12 years old with OHCA of a presumed cardiac cause, and in whom resuscitation was attempted, were identified through the Danish Cardiac Arrest Registry 2001-2010. A total of 19,372 patients were included. Results: One-third were female, with a median age of 75 years (IQR 65-83). Compared to females, males were five years younger; and less likely to have severe comorbidities, e.g., chronic obstructive pulmonary disease (12.8% vs. 16.5%); but more likely to have arrest outside of the home (29.4% vs. 18.7%), receive bystander CPR (32.9% vs. 25.9%), and have a shockable rhythm (32.6% vs. 17.2%), all p<. 0.001. Thirty-day crude survival increased in males (3.0% in 2001 to 12.9% in 2010); and in females (4.8% in 2001 to 6.7% in 2010), p<. 0.001.Multivariable logistic regression analyses adjusted for patient characteristics including comorbidities, showed no survival difference between sexes in patients with a non-shockable rhythm (OR 1.00; CI 0.72-1.40), while female sex was positively associated with survival in patients with a shockable rhythm (OR 1.31; CI 1.07-1.59). Analyses were rhythm-stratified due to interaction between sex and heart rhythm; there was no interaction between sex and calendar-year. Conclusions: Temporal increase in crude survival was more marked in males due to poorer prognostic characteristics in females with a lower proportion of shockable rhythm. In an adjusted model, female sex was positively associated with survival in patients with a shockable rhythm.

AB - Aim: Crude survival has increased following an out-of-hospital cardiac arrest (OHCA). We aimed to study sex-related differences in patient characteristics and survival during a 10-year study period. Methods: Patients ≥12 years old with OHCA of a presumed cardiac cause, and in whom resuscitation was attempted, were identified through the Danish Cardiac Arrest Registry 2001-2010. A total of 19,372 patients were included. Results: One-third were female, with a median age of 75 years (IQR 65-83). Compared to females, males were five years younger; and less likely to have severe comorbidities, e.g., chronic obstructive pulmonary disease (12.8% vs. 16.5%); but more likely to have arrest outside of the home (29.4% vs. 18.7%), receive bystander CPR (32.9% vs. 25.9%), and have a shockable rhythm (32.6% vs. 17.2%), all p<. 0.001. Thirty-day crude survival increased in males (3.0% in 2001 to 12.9% in 2010); and in females (4.8% in 2001 to 6.7% in 2010), p<. 0.001.Multivariable logistic regression analyses adjusted for patient characteristics including comorbidities, showed no survival difference between sexes in patients with a non-shockable rhythm (OR 1.00; CI 0.72-1.40), while female sex was positively associated with survival in patients with a shockable rhythm (OR 1.31; CI 1.07-1.59). Analyses were rhythm-stratified due to interaction between sex and heart rhythm; there was no interaction between sex and calendar-year. Conclusions: Temporal increase in crude survival was more marked in males due to poorer prognostic characteristics in females with a lower proportion of shockable rhythm. In an adjusted model, female sex was positively associated with survival in patients with a shockable rhythm.

U2 - 10.1016/j.resuscitation.2014.06.008

DO - 10.1016/j.resuscitation.2014.06.008

M3 - Journal article

C2 - 24960430

SN - 0300-9572

VL - 85

SP - 1212

EP - 1218

JO - Resuscitation

JF - Resuscitation

IS - 9

ER -

Survival after out-of-hospital cardiac arrest in relation to sex: A nationwide registry-based study

Abstract

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