Abstract 126: Does a Difference in Bystander Cardiopulmonary Resuscitation Initiation and Continuation Exist Due to Patient Sex After Accounting for the Bystander-Patient Relationship?

Abstract

Introduction/Background: Differences in bystander cardiopulmonary resuscitation (B-CPR) provision based on the patient’s sex have been reported extensively, with equivocal results. Research question: Do differences in B-CPR according to the patient’s sex exist after adjusting for the bystander-patient relationship? Aim: To explore sex differences in B-CPR initiation and continuation for out-of-hospital cardiac arrest (OHCA) patients while accounting for the bystander-patient relationship. Methods: We analysed consecutive paramedic-confirmed OHCA emergency calls, from 1 January to 30 April 2021, in Western Australia. Calls included were non-traumatic, non- emergency medical service (EMS)-witnessed OHCA, where the bystander was with the patient and CPR was not already in progress. Calls were reviewed in full, and patient and bystander characteristics were coded. Bystander relationship was categorised as either related to the patient or unrelated. We performed a logistic regression of B-CPR initiation by sex, adjusting for patient age (<65 and ≥65) and location (private and public), and bystander-patient relationship. Results: Of the 295 calls included, 203 (69%) of the patients were male, and 164 (56%) were over 65 years of age. Two thirds of the bystanders (65%) were related to the patient. The majority of OHCAs were in private locations (84%). Bystander CPR was initiated in 205 (69%) calls, 69% (139 out of 201) in male patients and 70% (66 out of 94) in female patients (p=0.85). There was no difference in CPR initiation between male and female patients, unadjusted (odds ratio, OR=0.95, 95% confidence interval, 95% CI = 0.56-1.62), or when adjusted for bystander-patient relationship, location, and patient age (OR=0.92, 95% CI=0.53-1.59). Of those who started CPR (205), 175 (85%) bystanders continued performing CPR till EMS arrived. Male OHCA patients were less likely to have CPR continue to EMS arrival than female OHCA patients (OR=0.46, 95% CI=0.16-1.29). Conclusion: There was no effect of patient sex on bystander CPR, both before and after accounting for bystander-patient relationship. Bystanders were more likely to continue performing CPR on female OHCA patients.