Sex-related differences of cerebral circumstances and clinical outcomes in patients with out-of-hospital cardiopulmonary arrest

Abstract

Purpose: This study was conducted to examine the sex-related differences of cerebral circumstances and clinical outcomes in patients with out-of-hospital cardiopulmonary arrest (OHCA). Methods: The Japan-Prediction of neurological Outcomes in patients Post cardiac arrest (J-POP) registry is a prospective, multicenter, cohort study to test whether regional cerebral oxygen saturation (rSO2) predicts neurological outcomes after non-traumatic OHCA. We measured rSO2 in OHCA patients immediately after hospital arrival using a near-infrared spectrometer placed on the forehead. Results: Since Japanese emergency medical service providers are not permitted to terminate resuscitation in the field, most patients with OHCA are transported to emergency hospitals. During the 15 months of the study, 1327 consecutive patients were studied, 39% of whom were women. Women were significantly older than men (mean age, 74.7±16 vs. 69.1±16 years; p <0.0001), with lower percentages of witnessed arrests (44.2% vs. 56.3%, p<0.0001), and out-of hospital defibrillation (7.8% vs. 20.2%, p<0.0001). Women had lower regional brain oxygen saturation (rSO2) at hospital arrival, lower chance of return of spontaneous circulation at hospital arrival (ROSC) and good neurological outcomes at 30 days. Furthermore in patients without ROSC at hospital arrival, women had also lower rSO2 at hospital arrival and poor neurological outcomes at 30 days (See Figure). ![Figure][1] rSO2 at hospital arrival and prognosis Conclusions: Different from many of previous reports, women had significantly worse cerebral circumstances at hospital arrival and worse neurological prognosis after OHCA in this study. Additional studies are required to validate these observations for other potential genetic factors and potential discrepancies with other reports. [1]: pending:yes