Abstract 18700: Impact of Gender on Clinical Outcomes in Adults With In-hospital Cardiac Arrest

Abstract

Background: Despite numerous advances in the delivery of resuscitative care, in-hospital cardiac arrest (IHCA) continues to be associated with high morbidity and mortality. We sought to study the impact of gender on return of spontaneous circulation (ROSC) and survival to discharge in patients with IHCA. Methods: The study population included 255 consecutive patients who underwent ACLS-guided resuscitation from January 2012- December2013 for IHCA at an academic tertiary medical center. Baseline demographic, clinical, laboratory, and clinical outcome data were recorded. Outcomes of interest included presence of sustained ROSC (defined as ROSC > 20 minutes) and survival to discharge. Results: Of the 255 patients studied, 96 (37.6%) were women and 159 (62.4%) were men. No difference in age, race, or ethnicity was noted between men and women. Women were shorter (160cm vs 174cm, p<0.001) and had lower weight (78kg vs 89kg, p<0.001), but had a trend towards higher body mass index (31.4 kg/m2 vs 29.4kg/m2, p=0.087). Women had lower rates of peripheral vascular disease (15.6% vs 27.0%, p=0.035) and hyperlipidemia (26.4% vs 41.6%, p=0.017). Rates of other comorbidities, including cardiovascular disease, chronic obstructive pulmonary disease, congestive heart failure, stroke, diabetes mellitus, chronic kidney disease, and hypertension were similar in men and women. Clinical presentation of IHCA, in particular, the initial rhythm, location of IHCA, duration of cardiopulmonary resuscitation, and laboratory results at the time of IHCA was similar in both men and women. With respect to outcomes, women were noted to have a trend toward lower rates of sustained ROSC (45.8% vs 57.9%, p=0.062) but no difference in survival to discharge (22.9% vs 27.0%, p=0.464). In multivariate analysis, gender was not an independent predictor of sustained ROSC or survival to discharge. Conclusion: Gender is not independently predictive of ROSC or survival to discharge in adults with IHCA.