Sex disparity in resuscitation efforts and outcomes in out-of-hospital cardiac arrest

Ki Ok Ahn, Sang Do Shin, Seung Sik Hwang

Research output: Contribution to journalArticle

30 Citations (Scopus)

Abstract

Objectives: The aim of this study was to investigate the association between sex, cardiopulmonary resuscitation efforts, and outcomes of out-of-hospital cardiac arrests in Korea. Methods: We used a nationwide, out-of-hospital cardiac arrest cohort database in 2008. We extracted cases involving patients older than 20 years with symptoms of presumed cardiac etiology. Potential predictors were collected using the Utstein style. The primary outcome was the resuscitation effort: basic life support and application of an automatic external defibrillator by emergency medical service providers, and advanced cardiac life support by emergency department physicians. Secondary outcomes were survival to admission and survival to discharge. Univariate and multivariate logistic regression models were applied by sex to calculate odds ratios and 95% confidence intervals adjusting for potential predictors. Results: The total number of eligible patients was 13 922. Of these, 5158 patients (37.0%) were female. Females were also less likely than males to receive basic life support (70.8% vs 77.5%, P <.001) or an automatic external defibrillator (9.6% vs 14.3%, P <.001), or receive advanced cardiac life support (42.2% vs 49.2%, P <.001). When compared with males, rates of survival to admission and discharge for females were 11.8% (vs 12.3%, P =.43) and 3.1% (vs 1.8%, P <.001), respectively. Adjusted odds ratios for survival to admission and survival to discharge for females, when compared with males, were 1.32 (1.17-1.48) and 0.82 (0.63-1.05), respectively. Conclusions: Females were less likely than males to receive resuscitation. Female sex was associated with a higher rate of survival at admission rate, whereas it was not associated with survival at discharge.

Original languageEnglish
Pages (from-to)1810-1816
Number of pages7
JournalAmerican Journal of Emergency Medicine
Volume30
Issue number9
DOIs
StatePublished - 1 Nov 2012

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Out-of-Hospital Cardiac Arrest
Resuscitation
Advanced Cardiac Life Support
Survival
Defibrillators
Survival Rate
Logistic Models
Odds Ratio
Cardiopulmonary Resuscitation
Emergency Medical Services
Korea
Hospital Emergency Service
Databases
Confidence Intervals
Physicians

Cite this

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title = "Sex disparity in resuscitation efforts and outcomes in out-of-hospital cardiac arrest",
abstract = "Objectives: The aim of this study was to investigate the association between sex, cardiopulmonary resuscitation efforts, and outcomes of out-of-hospital cardiac arrests in Korea. Methods: We used a nationwide, out-of-hospital cardiac arrest cohort database in 2008. We extracted cases involving patients older than 20 years with symptoms of presumed cardiac etiology. Potential predictors were collected using the Utstein style. The primary outcome was the resuscitation effort: basic life support and application of an automatic external defibrillator by emergency medical service providers, and advanced cardiac life support by emergency department physicians. Secondary outcomes were survival to admission and survival to discharge. Univariate and multivariate logistic regression models were applied by sex to calculate odds ratios and 95{\%} confidence intervals adjusting for potential predictors. Results: The total number of eligible patients was 13 922. Of these, 5158 patients (37.0{\%}) were female. Females were also less likely than males to receive basic life support (70.8{\%} vs 77.5{\%}, P <.001) or an automatic external defibrillator (9.6{\%} vs 14.3{\%}, P <.001), or receive advanced cardiac life support (42.2{\%} vs 49.2{\%}, P <.001). When compared with males, rates of survival to admission and discharge for females were 11.8{\%} (vs 12.3{\%}, P =.43) and 3.1{\%} (vs 1.8{\%}, P <.001), respectively. Adjusted odds ratios for survival to admission and survival to discharge for females, when compared with males, were 1.32 (1.17-1.48) and 0.82 (0.63-1.05), respectively. Conclusions: Females were less likely than males to receive resuscitation. Female sex was associated with a higher rate of survival at admission rate, whereas it was not associated with survival at discharge.",
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Sex disparity in resuscitation efforts and outcomes in out-of-hospital cardiac arrest. / Ahn, Ki Ok; Shin, Sang Do; Hwang, Seung Sik.

In: American Journal of Emergency Medicine, Vol. 30, No. 9, 01.11.2012, p. 1810-1816.

Research output: Contribution to journalArticle

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N2 - Objectives: The aim of this study was to investigate the association between sex, cardiopulmonary resuscitation efforts, and outcomes of out-of-hospital cardiac arrests in Korea. Methods: We used a nationwide, out-of-hospital cardiac arrest cohort database in 2008. We extracted cases involving patients older than 20 years with symptoms of presumed cardiac etiology. Potential predictors were collected using the Utstein style. The primary outcome was the resuscitation effort: basic life support and application of an automatic external defibrillator by emergency medical service providers, and advanced cardiac life support by emergency department physicians. Secondary outcomes were survival to admission and survival to discharge. Univariate and multivariate logistic regression models were applied by sex to calculate odds ratios and 95% confidence intervals adjusting for potential predictors. Results: The total number of eligible patients was 13 922. Of these, 5158 patients (37.0%) were female. Females were also less likely than males to receive basic life support (70.8% vs 77.5%, P <.001) or an automatic external defibrillator (9.6% vs 14.3%, P <.001), or receive advanced cardiac life support (42.2% vs 49.2%, P <.001). When compared with males, rates of survival to admission and discharge for females were 11.8% (vs 12.3%, P =.43) and 3.1% (vs 1.8%, P <.001), respectively. Adjusted odds ratios for survival to admission and survival to discharge for females, when compared with males, were 1.32 (1.17-1.48) and 0.82 (0.63-1.05), respectively. Conclusions: Females were less likely than males to receive resuscitation. Female sex was associated with a higher rate of survival at admission rate, whereas it was not associated with survival at discharge.

AB - Objectives: The aim of this study was to investigate the association between sex, cardiopulmonary resuscitation efforts, and outcomes of out-of-hospital cardiac arrests in Korea. Methods: We used a nationwide, out-of-hospital cardiac arrest cohort database in 2008. We extracted cases involving patients older than 20 years with symptoms of presumed cardiac etiology. Potential predictors were collected using the Utstein style. The primary outcome was the resuscitation effort: basic life support and application of an automatic external defibrillator by emergency medical service providers, and advanced cardiac life support by emergency department physicians. Secondary outcomes were survival to admission and survival to discharge. Univariate and multivariate logistic regression models were applied by sex to calculate odds ratios and 95% confidence intervals adjusting for potential predictors. Results: The total number of eligible patients was 13 922. Of these, 5158 patients (37.0%) were female. Females were also less likely than males to receive basic life support (70.8% vs 77.5%, P <.001) or an automatic external defibrillator (9.6% vs 14.3%, P <.001), or receive advanced cardiac life support (42.2% vs 49.2%, P <.001). When compared with males, rates of survival to admission and discharge for females were 11.8% (vs 12.3%, P =.43) and 3.1% (vs 1.8%, P <.001), respectively. Adjusted odds ratios for survival to admission and survival to discharge for females, when compared with males, were 1.32 (1.17-1.48) and 0.82 (0.63-1.05), respectively. Conclusions: Females were less likely than males to receive resuscitation. Female sex was associated with a higher rate of survival at admission rate, whereas it was not associated with survival at discharge.

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