Is female sex associated with increased survival after out-of-hospital cardiac arrest?
Is female sex associated with increased survival after out-of-hospital cardiac arrest?
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DOI：
10.1016/j.resuscitation.2003.09.012
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发表时间：
2004-02-01
期刊：
影响因子：
6.5
通讯作者：
Holmberg, S
中科院分区：
文献类型：
--
作者：
Herlitz, J;Engdahl, J;Holmberg, S
目的：评估院外心脏骤停后的生存率与性别的关系。研究方法：纳入了1990年至2000年期间瑞典心脏骤停登记处纳入的所有院外心脏骤停患者，其中尝试了心肺复苏术（CPR），并且没有机组人员见证骤停。该登记册涵盖了瑞典85%的居民（约800万居民）。根据年龄差异调整P值。生存期定义为患者在住院期间存活，且在心脏骤停后1个月存活。共有23，797名患者参加了调查，其中27.9%为女性。结果：女性中16.4%的患者住院后存活，男性中13.2%的患者存活（P < 0.001）。一个月后，3.0%的女性存活，而男性为3.4%（NS）。在一项多变量分析中，考虑到复苏时年龄和各种因素的差异，女性是患者住院存活（比值比1.66; 95%置信区间1.49-1.84）和1个月后存活（比值比1.27; 95%置信区间1.03-1.56）的独立预测因素。随着年龄的增长，妇女与男子的情况有所不同（P < 0.001），有较低的发生率目睹心脏骤停（P = 0.01）、旁观者CPR的发生率较低（P < 0.001）、室颤作为初始心律失常的发生率较低（P < 0.001）和被判定为心脏骤停原因的心脏病的发生率较低（P < 0.0001）。另一方面，他们在家中发生心脏骤停的频率更高（P < 0.001）。结论：在瑞典发生院外心脏骤停的患者中，没有机组人员在场，并尝试进行复苏，女性与生存率增加相关。(C)2003爱思唯尔爱尔兰有限公司保留所有权利。
Aim: To evaluate survival after out-of-hospital cardiac arrest in relation to sex. Methods: All patients with out-of-hospital cardiac arrest included in the Swedish Cardiac Arrest Registry between 1990 and 2000 in whom cardiopulmonary resuscitation (CPR) was attempted and who did not have a crew witnessed arrest were included. The registry covers 85% of the inhabitants of Sweden (approximately 8 million inhabitants). P-values were adjusted to differences in age. Survival was defined as patients being hospitalised alive and being alive one month after cardiac arrest. In all, 23,797 patients participated in the survey of which 27.9% were women. Results: Among women 16.4% were hospitalised alive versus 13.2% among men (P < 0.001). After one month 3.0% among women were alive versus 3.4% among men (NS). In a multivariate analysis considering differences in age and various factors at resuscitation female sex was an independent predictor for patients being hospitalised alive (odds ratio 1.66; 95% confidence limits 1.49-1.84) and for being alive after one month (odds ratio 1.27; 95% confidence limits 1.03-1.56). Women differed from men as they were older (P < 0.001), had a lower prevalence of witnessed cardiac arrest (P = 0.01), a lower occurrence of bystander CPR (P < 0.001), a lower occurrence of ventricular fibrillation as initial arrhythmia (P < 0.001) and a lower occurrence of cardiac disease judged to be the cause of cardiac arrest (P < 0.0001). On the other hand they had a cardiac arrest at home more frequently (P < 0.001). Conclusion: Among patients suffering out-of-hospital cardiac arrest in Sweden which was not crew witnessed and in whom resuscitation efforts were attempted, female sex was associated with an increased survival. (C) 2003 Elsevier Ireland Ltd. All rights reserved.