Association of gender to outcome after out-of-hospital cardiac arrest - a report from the International Cardiac Arrest Registry

Viktor Karlsson, Josef Dankiewicz, Niklas Nielsen, Karl B Kern, Michael R. Mooney, Richard R. Riker, Sten Rubertsson, David B. Seder, Pascal Stammet, Kjetil Sunde, Eldar Søreide, Barbara T. Unger, Hans Friberg

Research output: Contribution to journalArticle

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Abstract

Introduction: Previous studies have suggested an effect of gender on outcome after out-of-hospital cardiac arrest (OHCA), but the results are conflicting. We aimed to investigate the association of gender to outcome, coronary angiography (CAG) and adverse events in OHCA survivors treated with mild induced hypothermia (MIH). Methods: We performed a retrospective analysis of prospectively collected data from the International Cardiac Arrest Registry. Adult patients with a non-traumatic OHCA and treated with MIH were included. Good neurological outcome was defined as a cerebral performance category (CPC) of 1 or 2. Results: A total of 1,667 patients, 472 women (28%) and 1,195 men (72%), met the inclusion criteria. Men were more likely to receive bystander cardiopulmonary resuscitation, have an initial shockable rhythm and to have a presumed cardiac cause of arrest. At hospital discharge, men had a higher survival rate (52% vs. 38%, P <0.001) and more often a good neurological outcome (43% vs. 32%, P <0.001) in the univariate analysis. When adjusting for baseline characteristics, male gender was associated with improved survival (OR 1.34, 95% CI 1.01 to 1.78) but no longer with neurological outcome (OR 1.24, 95% CI 0.92 to 1.67). Adverse events were common; women more often had hypokalemia, hypomagnesemia and bleeding requiring transfusion, while men had more pneumonia. In a subgroup analysis of patients with a presumed cardiac cause of arrest (n = 1,361), men more often had CAG performed on admission (58% vs. 50%, P = 0.02) but this discrepancy disappeared in an adjusted analysis. Conclusions: Gender differences exist regarding cause of arrest, adverse events and outcome. Male gender was independently associated with survival but not with neurological outcome.

Original languageEnglish (US)
Article number182
JournalCritical Care
Volume19
Issue number1
DOIs
StatePublished - Apr 21 2015

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Out-of-Hospital Cardiac Arrest
Heart Arrest
Registries
Induced Hypothermia
Coronary Angiography
Survival
Hypokalemia
Cardiopulmonary Resuscitation
Survivors
Pneumonia
Survival Rate
Hemorrhage

ASJC Scopus subject areas

  • Critical Care and Intensive Care Medicine

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Association of gender to outcome after out-of-hospital cardiac arrest - a report from the International Cardiac Arrest Registry. / Karlsson, Viktor; Dankiewicz, Josef; Nielsen, Niklas; Kern, Karl B; Mooney, Michael R.; Riker, Richard R.; Rubertsson, Sten; Seder, David B.; Stammet, Pascal; Sunde, Kjetil; Søreide, Eldar; Unger, Barbara T.; Friberg, Hans.

In: Critical Care, Vol. 19, No. 1, 182, 21.04.2015.

Research output: Contribution to journalArticle

Karlsson, V, Dankiewicz, J, Nielsen, N, Kern, KB, Mooney, MR, Riker, RR, Rubertsson, S, Seder, DB, Stammet, P, Sunde, K, Søreide, E, Unger, BT & Friberg, H 2015, 'Association of gender to outcome after out-of-hospital cardiac arrest - a report from the International Cardiac Arrest Registry', Critical Care, vol. 19, no. 1, 182. https://doi.org/10.1186/s13054-015-0904-y
Karlsson, Viktor ; Dankiewicz, Josef ; Nielsen, Niklas ; Kern, Karl B ; Mooney, Michael R. ; Riker, Richard R. ; Rubertsson, Sten ; Seder, David B. ; Stammet, Pascal ; Sunde, Kjetil ; Søreide, Eldar ; Unger, Barbara T. ; Friberg, Hans. / Association of gender to outcome after out-of-hospital cardiac arrest - a report from the International Cardiac Arrest Registry. In: Critical Care. 2015 ; Vol. 19, No. 1.
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abstract = "Introduction: Previous studies have suggested an effect of gender on outcome after out-of-hospital cardiac arrest (OHCA), but the results are conflicting. We aimed to investigate the association of gender to outcome, coronary angiography (CAG) and adverse events in OHCA survivors treated with mild induced hypothermia (MIH). Methods: We performed a retrospective analysis of prospectively collected data from the International Cardiac Arrest Registry. Adult patients with a non-traumatic OHCA and treated with MIH were included. Good neurological outcome was defined as a cerebral performance category (CPC) of 1 or 2. Results: A total of 1,667 patients, 472 women (28{\%}) and 1,195 men (72{\%}), met the inclusion criteria. Men were more likely to receive bystander cardiopulmonary resuscitation, have an initial shockable rhythm and to have a presumed cardiac cause of arrest. At hospital discharge, men had a higher survival rate (52{\%} vs. 38{\%}, P <0.001) and more often a good neurological outcome (43{\%} vs. 32{\%}, P <0.001) in the univariate analysis. When adjusting for baseline characteristics, male gender was associated with improved survival (OR 1.34, 95{\%} CI 1.01 to 1.78) but no longer with neurological outcome (OR 1.24, 95{\%} CI 0.92 to 1.67). Adverse events were common; women more often had hypokalemia, hypomagnesemia and bleeding requiring transfusion, while men had more pneumonia. In a subgroup analysis of patients with a presumed cardiac cause of arrest (n = 1,361), men more often had CAG performed on admission (58{\%} vs. 50{\%}, P = 0.02) but this discrepancy disappeared in an adjusted analysis. Conclusions: Gender differences exist regarding cause of arrest, adverse events and outcome. Male gender was independently associated with survival but not with neurological outcome.",
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AU - Karlsson, Viktor

AU - Dankiewicz, Josef

AU - Nielsen, Niklas

AU - Kern, Karl B

AU - Mooney, Michael R.

AU - Riker, Richard R.

AU - Rubertsson, Sten

AU - Seder, David B.

AU - Stammet, Pascal

AU - Sunde, Kjetil

AU - Søreide, Eldar

AU - Unger, Barbara T.

AU - Friberg, Hans

PY - 2015/4/21

Y1 - 2015/4/21

N2 - Introduction: Previous studies have suggested an effect of gender on outcome after out-of-hospital cardiac arrest (OHCA), but the results are conflicting. We aimed to investigate the association of gender to outcome, coronary angiography (CAG) and adverse events in OHCA survivors treated with mild induced hypothermia (MIH). Methods: We performed a retrospective analysis of prospectively collected data from the International Cardiac Arrest Registry. Adult patients with a non-traumatic OHCA and treated with MIH were included. Good neurological outcome was defined as a cerebral performance category (CPC) of 1 or 2. Results: A total of 1,667 patients, 472 women (28%) and 1,195 men (72%), met the inclusion criteria. Men were more likely to receive bystander cardiopulmonary resuscitation, have an initial shockable rhythm and to have a presumed cardiac cause of arrest. At hospital discharge, men had a higher survival rate (52% vs. 38%, P <0.001) and more often a good neurological outcome (43% vs. 32%, P <0.001) in the univariate analysis. When adjusting for baseline characteristics, male gender was associated with improved survival (OR 1.34, 95% CI 1.01 to 1.78) but no longer with neurological outcome (OR 1.24, 95% CI 0.92 to 1.67). Adverse events were common; women more often had hypokalemia, hypomagnesemia and bleeding requiring transfusion, while men had more pneumonia. In a subgroup analysis of patients with a presumed cardiac cause of arrest (n = 1,361), men more often had CAG performed on admission (58% vs. 50%, P = 0.02) but this discrepancy disappeared in an adjusted analysis. Conclusions: Gender differences exist regarding cause of arrest, adverse events and outcome. Male gender was independently associated with survival but not with neurological outcome.

AB - Introduction: Previous studies have suggested an effect of gender on outcome after out-of-hospital cardiac arrest (OHCA), but the results are conflicting. We aimed to investigate the association of gender to outcome, coronary angiography (CAG) and adverse events in OHCA survivors treated with mild induced hypothermia (MIH). Methods: We performed a retrospective analysis of prospectively collected data from the International Cardiac Arrest Registry. Adult patients with a non-traumatic OHCA and treated with MIH were included. Good neurological outcome was defined as a cerebral performance category (CPC) of 1 or 2. Results: A total of 1,667 patients, 472 women (28%) and 1,195 men (72%), met the inclusion criteria. Men were more likely to receive bystander cardiopulmonary resuscitation, have an initial shockable rhythm and to have a presumed cardiac cause of arrest. At hospital discharge, men had a higher survival rate (52% vs. 38%, P <0.001) and more often a good neurological outcome (43% vs. 32%, P <0.001) in the univariate analysis. When adjusting for baseline characteristics, male gender was associated with improved survival (OR 1.34, 95% CI 1.01 to 1.78) but no longer with neurological outcome (OR 1.24, 95% CI 0.92 to 1.67). Adverse events were common; women more often had hypokalemia, hypomagnesemia and bleeding requiring transfusion, while men had more pneumonia. In a subgroup analysis of patients with a presumed cardiac cause of arrest (n = 1,361), men more often had CAG performed on admission (58% vs. 50%, P = 0.02) but this discrepancy disappeared in an adjusted analysis. Conclusions: Gender differences exist regarding cause of arrest, adverse events and outcome. Male gender was independently associated with survival but not with neurological outcome.

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