Association of gender to outcome after out-of-hospital cardiac arrest - a report from the International Cardiac Arrest Registry

Persistent Link:
http://hdl.handle.net/10150/610310
Title:
Association of gender to outcome after out-of-hospital cardiac arrest - a report from the International Cardiac Arrest Registry
Author:
Karlsson, Viktor; Dankiewicz, Josef; Nielsen, Niklas; Kern, Karl B.; Mooney, Michael R.; Riker, Richard R.; Rubertsson, Sten; Seder, David B.; Stammet, Pascal; Sunde, Kjetil; Søreide, Eldar; Unger, Barbara T.; Friberg, Hans
Affiliation:
Department of Clinical Sciences, Lund University; Department of Anaesthesiology and Intensive Care, Skåne University Hospital; Department of Anaesthesiology and Intensive Care, Helsingborg Hospital; Sarver Heart Center, University of Arizona; Minneapolis Heart Institute Foundation, Abbot Northwestern Hospital; Department of Critical Care Services and Neuroscience Institute, Maine Medical Center; Department of Surgical Sciences/Anaesthesiology and Intensive Care, Uppsala University; Department of Anesthesia and Intensive Care, Centre Hospitalier de Luxembourg; Department of Anaesthesiology, Surgical ICU Ullevål, Oslo University Hospital; Department of Anaesthesiology and Intensive Care, Stavanger University Hospital; Department of Clinical Medicine, University of Bergen
Issue Date:
2015
Publisher:
BioMed Central Ltd
Citation:
Karlsson et al. Critical Care (2015) 19:182 DOI 10.1186/s13054-015-0904-y
Journal:
Critical Care
Rights:
© 2015 Karlsson et al.; licensee BioMed Central. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0)
Collection Information:
This item is part of the UA Faculty Publications collection. For more information this item or other items in the UA Campus Repository, contact the University of Arizona Libraries at repository@u.library.arizona.edu.
Abstract:
INTRODUCTION: Previous studies have suggested an effect of gender on outcome after out-of-hospital cardiac arrest (OHCA), but the results are conflicting. We aimed to investigate the association of gender to outcome, coronary angiography (CAG) and adverse events in OHCA survivors treated with mild induced hypothermia (MIH). METHODS: We performed a retrospective analysis of prospectively collected data from the International Cardiac Arrest Registry. Adult patients with a non-traumatic OHCA and treated with MIH were included. Good neurological outcome was defined as a cerebral performance category (CPC) of 1 or 2. RESULTS: A total of 1,667 patients, 472 women (28%) and 1,195 men (72%), met the inclusion criteria. Men were more likely to receive bystander cardiopulmonary resuscitation, have an initial shockable rhythm and to have a presumed cardiac cause of arrest. At hospital discharge, men had a higher survival rate (52% vs. 38%, P <0.001) and more often a good neurological outcome (43% vs. 32%, P <0.001) in the univariate analysis. When adjusting for baseline characteristics, male gender was associated with improved survival (OR 1.34, 95% CI 1.01 to 1.78) but no longer with neurological outcome (OR 1.24, 95% CI 0.92 to 1.67). Adverse events were common; women more often had hypokalemia, hypomagnesemia and bleeding requiring transfusion, while men had more pneumonia. In a subgroup analysis of patients with a presumed cardiac cause of arrest (n = 1,361), men more often had CAG performed on admission (58% vs. 50%, P = 0.02) but this discrepancy disappeared in an adjusted analysis. CONCLUSIONS: Gender differences exist regarding cause of arrest, adverse events and outcome. Male gender was independently associated with survival but not with neurological outcome.
EISSN:
1466-609X
DOI:
10.1186/s13054-015-0904-y
Version:
Final published version
Additional Links:
http://www.ccforum.com/content/19/1/182

Full metadata record

DC FieldValue Language
dc.contributor.authorKarlsson, Viktoren
dc.contributor.authorDankiewicz, Josefen
dc.contributor.authorNielsen, Niklasen
dc.contributor.authorKern, Karl B.en
dc.contributor.authorMooney, Michael R.en
dc.contributor.authorRiker, Richard R.en
dc.contributor.authorRubertsson, Stenen
dc.contributor.authorSeder, David B.en
dc.contributor.authorStammet, Pascalen
dc.contributor.authorSunde, Kjetilen
dc.contributor.authorSøreide, Eldaren
dc.contributor.authorUnger, Barbara T.en
dc.contributor.authorFriberg, Hansen
dc.date.accessioned2016-05-20T09:03:53Z-
dc.date.available2016-05-20T09:03:53Z-
dc.date.issued2015en
dc.identifier.citationKarlsson et al. Critical Care (2015) 19:182 DOI 10.1186/s13054-015-0904-yen
dc.identifier.doi10.1186/s13054-015-0904-yen
dc.identifier.urihttp://hdl.handle.net/10150/610310-
dc.description.abstractINTRODUCTION: Previous studies have suggested an effect of gender on outcome after out-of-hospital cardiac arrest (OHCA), but the results are conflicting. We aimed to investigate the association of gender to outcome, coronary angiography (CAG) and adverse events in OHCA survivors treated with mild induced hypothermia (MIH). METHODS: We performed a retrospective analysis of prospectively collected data from the International Cardiac Arrest Registry. Adult patients with a non-traumatic OHCA and treated with MIH were included. Good neurological outcome was defined as a cerebral performance category (CPC) of 1 or 2. RESULTS: A total of 1,667 patients, 472 women (28%) and 1,195 men (72%), met the inclusion criteria. Men were more likely to receive bystander cardiopulmonary resuscitation, have an initial shockable rhythm and to have a presumed cardiac cause of arrest. At hospital discharge, men had a higher survival rate (52% vs. 38%, P <0.001) and more often a good neurological outcome (43% vs. 32%, P <0.001) in the univariate analysis. When adjusting for baseline characteristics, male gender was associated with improved survival (OR 1.34, 95% CI 1.01 to 1.78) but no longer with neurological outcome (OR 1.24, 95% CI 0.92 to 1.67). Adverse events were common; women more often had hypokalemia, hypomagnesemia and bleeding requiring transfusion, while men had more pneumonia. In a subgroup analysis of patients with a presumed cardiac cause of arrest (n = 1,361), men more often had CAG performed on admission (58% vs. 50%, P = 0.02) but this discrepancy disappeared in an adjusted analysis. CONCLUSIONS: Gender differences exist regarding cause of arrest, adverse events and outcome. Male gender was independently associated with survival but not with neurological outcome.en
dc.language.isoenen
dc.publisherBioMed Central Ltden
dc.relation.urlhttp://www.ccforum.com/content/19/1/182en
dc.rights© 2015 Karlsson et al.; licensee BioMed Central. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0)en
dc.titleAssociation of gender to outcome after out-of-hospital cardiac arrest - a report from the International Cardiac Arrest Registryen
dc.typeArticleen
dc.identifier.eissn1466-609Xen
dc.contributor.departmentDepartment of Clinical Sciences, Lund Universityen
dc.contributor.departmentDepartment of Anaesthesiology and Intensive Care, Skåne University Hospitalen
dc.contributor.departmentDepartment of Anaesthesiology and Intensive Care, Helsingborg Hospitalen
dc.contributor.departmentSarver Heart Center, University of Arizonaen
dc.contributor.departmentMinneapolis Heart Institute Foundation, Abbot Northwestern Hospitalen
dc.contributor.departmentDepartment of Critical Care Services and Neuroscience Institute, Maine Medical Centeren
dc.contributor.departmentDepartment of Surgical Sciences/Anaesthesiology and Intensive Care, Uppsala Universityen
dc.contributor.departmentDepartment of Anesthesia and Intensive Care, Centre Hospitalier de Luxembourgen
dc.contributor.departmentDepartment of Anaesthesiology, Surgical ICU Ullevål, Oslo University Hospitalen
dc.contributor.departmentDepartment of Anaesthesiology and Intensive Care, Stavanger University Hospitalen
dc.contributor.departmentDepartment of Clinical Medicine, University of Bergenen
dc.identifier.journalCritical Careen
dc.description.collectioninformationThis item is part of the UA Faculty Publications collection. For more information this item or other items in the UA Campus Repository, contact the University of Arizona Libraries at repository@u.library.arizona.edu.en
dc.eprint.versionFinal published versionen
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