Abstract 189: Time to Awakening in Women Compared to Men After Out-Of-Hospital Cardiac Arrest

Abstract

Background: Previous studies have shown that comatose survivors of cardiac arrest awaken approximately 3 days after return of spontaneous circulation (ROSC) however, variability in time to awakening is frequently observed. Recent data has shown that women metabolize drugs (sedatives and paralytics) differently than men. It is unknown if there are sex based differences in time to awakening for comatose survivors of cardiac arrest, and if this phenomenon might be affected by differences in withdrawal of life sustaining therapy (WLST). Objective: To determine if comatose women have different times to awakening after resuscitation from cardiac arrest. Methods: We analyzed 327 consecutive charts from a single center registry of all out of hospital cardiac arrest patients who had return of spontaneous circulation but remained comatose, cared for at an urban academic tertiary care hospital. Patient demographic and arrest characteristics were abstracted. We identified day of awakening for comatose survivors by abstracting day when Glasgow coma motor score was 6 as documented in nursing flowsheets. Time to withdrawal of life sustaining therapy was also abstracted for the cohort that did not awaken. Patients were excluded from analysis if they did not awaken or if they died for reasons other than WLST. Results: Twenty-eight percent of patients woke prior to hospital discharge and 43.4% underwent withdrawal of life sustaining therapy. Women made up 39.5% of the total cohort, 40% of the awakened cohort and 41% of the WLST cohort. Women had earlier day of awakening in comparison to men (day 2 (2, 4) vs. day 4 (2,5), p=0.0036), and also earlier time to WLST after ROSC than men (59 hours (26, 131) vs. 64 hours (22, 135), p=NS). Conclusion: In this single center cohort, there was a difference in time to awakening between men and women. How time to awakening might differ between the sexes with guideline concordant time to WLST is unknown. Further research is necessary to explore the role of therapeutic interventions and differing physiology between men and women as it applies to time to awakening.