Abstract 144: Impact Of Gender On Outcomes In The Extracorporeal Cardiopulmonary Resuscitation Population For Out-of-hospital Cardiac Arrest

Abstract

Introduction: Extracorporeal Cardiopulmonary Resuscitation ( ECPR) is associated with improved neurologically favorable survival for refractory ventricular tachycardia/ventricular fibrillation (VT/VF) arrests. Women are known to have less coronary artery disease, and it is unknown if the lack of a reversible cause would be associated with worse outcomes after ECPR. Hypothesis: We hypothesize that female gender may be associated with worse outcomes after ECPR. Methods: Patients who presented for refractory VT/VF arrest between 2015 and 2021 were included. The primary outcomes included overall survival at 36 months and neurologically favorable survival on discharge (Cerebral Performance Categories scales of 1 or 2). Secondary outcomes included cardiopulmonary resuscitation (CPR) time, median lactate level on presentation, and bystander CPR. Results: Out of 357 patients who presented for out-of-hospital cardiac arrest, 68 patients (19%) were female. The median age for females was 57 years (IQR 57-52) and for males was 59 years (IQR 50-66). Women were more likely to receive ECPR and not to be excluded (5.9% of women were excluded vs. 14.9%, p=0.048) and were less likely to have obstructive coronary disease on coronary angiogram at presentation (39.5% vs. 62.9%, p=0.005). There was no difference in neurologically favorable survival based on gender (39.1% in women vs. 33.7%, p=0.42) nor 36 months survival (p= 0.58, figure). There was also no difference in median CPR time (62 minutes (IQR 51-76) in women vs. 59 minutes (IQR 45-70), p=0.16), median lactate levels (11.5 mmol/L (IQR 8-14.8) in women vs. 11.6 mmol/L (IQR 8.7-14.7), p=0.95), and in receiving bystander CPR (65.6% in women vs. 70.1%, p=0.49). Conclusion: There is no difference in neurologically favorable survival or overall survival based on gender in ECPR patients who had an out-of-hospital cardiac arrest, despite the difference in the prevalence of obstructive coronary artery disease on presentation.