Abstract 290: Sex Disparities in Chest Compression Quality

Abstract

BACKGROUND: Multiple studies have documented improved outcomes from cardiac arrest for women compared to men, but the etiology of this disparity is unknown. Prior out-of-hospital work has suggested that men have stiffer chests than women, requiring more force to compress the same depth. We hypothesized that this would result in women receiving deeper chest compressions during CPR. METHODS: We conducted a prospective study of consecutive, adult, index in-hospital cardiac arrests within a single academic institution between April 2006 and March 2011. CPR quality measures were recorded using a CPR-recording defibrillator (MRX/QCPR, Philips Healthcare). Force data were available for only a subset (n=69). Paired t-tests and chi-squared analyses were used to compare patient demographics, CPR quality parameters and outcomes by sex. RESULTS: A total of 503 patients were included in the analysis, of which 53% were women. Results are shown in the table below. Women received deeper chest compressions (48±8mm vs 46±8mm, p=0.005) with higher duty cycles (0.39±0.03 vs 0.38±0.03, p=0.001) and a trend toward decreased leaning compared to men. This was associated with a trend toward improved return of spontaneous circulation (ROSC) and survival to discharge in women. In the subset for whom force data were available, women required less elastic force to reach 5 cm of compression depth (24.5 ± 5.7 kg vs 30.5 ± 8.8 kg, p<0.001), even after adjusting for body mass index (BMI), age, and arrest location (p=0.004). CONCLUSION: Men have stiffer chest and receive shallower chest compressions than their female counterparts. This may be a contributor to the differences in survival noted in prior studies. Rescuers should be aware of the need to push harder for male victims of cardiac arrest.