Abstract 18692: Survival From Sudden Cardiac Arrest in Women Compared to Men

Abstract

Introduction: There is controversy regarding comparative survival from sudden cardiac arrest (SCA) between the sexes that needs further investigation. Hypothesis: Women present with a better outcome after resuscitation for SCA, compared to men. Methods: Female and male SCA cases aged 15-75 years were pooled and compared from 2 large community-based SCA programs across the Atlantic, a Northwestern US metro region and the Greater Paris, France metro area. We compared incidence, characteristics, and outcome (return of spontaneous circulation, ROSC). Results: Of the 7,357 SCA cases, 1783 (24.8%) were female, an incidence of 22.8 (95% CI 22.6-23.0) per 100,000 per year. Compared to men, the overall relative risk of SCA in women was 0.46 (95% CI 0.40-0.54) in US and 0.32 (95% CI 0.31-0.33) in France. Women were older (mean age 57.5±13 vs. 56.3±12, P<0.001), with higher rates of diabetes (40.4 vs. 35.6%, P=0.02) and hypertension (59.0 vs. 53.0%, P=0.006), lower proportion witnessed (63.9 vs. 70.0%, P<0.001), with less bystander cardiopulmonary resuscitation (29.0 vs. 32.3%, P<0.01), and lower proportion of ventricular fibrillation (28.7 vs. 42.4%, P<0.001). Response times were not statistically different in women compared to men (P=0.25). Proportion of ROSC was similar in both sexes (27.82 vs. 27.85%, P=0.98). After adjustment for confounding factors, women were associated with better outcome (OR 1.54, 95% CI 1.30-1.82, P<0.001): 1.35 (95% CI 1.10-1.69, P=0.006) in US, and 1.72 (95% CI 1.28-2.32, P<0.001) in France. Conclusions: SCD in women has distinct characteristics and outcome compared to SCD in men. Our results suggest higher propensity for survival in women compared to men that warrants further investigation.