Abstract
BackgroundCardiac arrest is more common in men than women and a few studies have shown inferior 30-day survival for men than for women. The difference might relate to patient characteristics, intra arrest factors or post arrest care.AimTo assess differences in 30-day survival between men and women after an in-hospital cardiac arrest (IHCA).Material and methodsAll patients ≥18 years suffering an IHCA at Karolinska University Hospital between 2007 and 2017 were included. Data regarding the IHCA, patient characteristics, Charlson co-morbidity index (CCI) and 30-day survival were obtained from electronic patient records. Differences in survival between men and women were assessed with adjusted logistic regression models and presented as Odds Ratios with 95% Confidence Intervals (OR, 95% CI). Adjustments included age, CCI, place of cardiac arrest, first rhythm, ECG-surveillance and witnessed or not.ResultsIn all, 1639 patients suffered an IHCA, of whom 650 (40%) were women and 193 (30%) of them survived to 30 days compared to 28% of the men. No differences were found in the studied patient characteristics, intra arrest factors or post-ROSC treatments. Men had similar survival as women (crude OR 0.93 95% CI 0.74–1.15 and adjusted OR 0.77 95% CI 0.58–1.03 respectively).ConclusionThis cohort study illuminates an almost equal distribution in characteristics and treatment as well as outcome, 30-day survival after IHCA between men and women. However, our study confirms previous findings of disadvantageous prerequisites among women, but also indicates that preceeding vital signs differ which might indicate residual confounding.
Highlights
The impact of sex on survival after cardiac arrest remains in the current situation somewhat unclear with conflicting results
Patient characteristics In all, 1639 patients suffered an in-hospital cardiac arrest (IHCA) at Karolinska during 2007–2017 and the overall 30-day survival ratio was 29%
This cohort study over 10 years illuminates an almost equal distribution of patient characteristics and cardiac arrest factors and possibly an equal 30-day survival after an IHCA for men and women
Summary
The impact of sex on survival after cardiac arrest remains in the current situation somewhat unclear with conflicting results. Previous studies show that men are overrepresented in the cardiac arrest population, constituting approximately 60% of all cases but have about a 10% lower chance of 30-day survival than women [1,2,3]. This decreased survival for men has been shown despite unfavourable prehospital factors among out-of-hospital cardiac arrests (OHCA) such as higher age, fewer witnessed arrests and less likely to receive bystander-CPR. We conducted a cohort study with the aim of assessing differences in patient characteristics, intra arrest factors as well as post-ROSC treatments between men and women as well as the association with gender and 30-day survival after an IHCA. The difference might relate to patient characteristics, intra arrest factors or post arrest care
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