Association of gender to outcome after out-of-hospital cardiac arrest--a report from the International Cardiac Arrest Registry.
Association of gender to outcome after out-of-hospital cardiac arrest--a report from the International Cardiac Arrest Registry.
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院外心脏骤停后的性别结合至结果 - 国际心脏骤停登记处的报告。
DOI：
10.1186/s13054-015-0904-y
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发表时间：
2015-04-21
期刊：
影响因子：
--
通讯作者：
Friberg H
中科院分区：
文献类型：
--
作者：
Karlsson V;Dankiewicz J;Nielsen N;Kern KB;Mooney MR;Riker RR;Rubertsson S;Seder DB;Stammet P;Sunde K;Søreide E;Unger BT;Friberg H
先前的研究表明，性别对院外心脏骤停（OHCA）后的结果有影响，但结果相互矛盾。我们的目的是调查性别与OHCA幸存者接受轻度诱发性低温（MIH）治疗的结局、冠状动脉造影（CAG）和不良事件的关系。我们对国际心脏骤停登记处前瞻性收集的数据进行了回顾性分析。包括非创伤性OHCA并接受MIH治疗的成年患者。良好的神经预后定义为脑功能分类（CPC）为1或2。共有1667例患者符合纳入标准，其中女性472例（28%），男性1195例（72%）。男性更有可能接受旁观者心肺复苏，有最初的休克性心律，并有假定的心脏骤停原因。出院时，在单变量分析中，男性生存率更高（52%对38%，P <0.001），神经系统预后更佳（43%对32%，P <0.001）。当调整基线特征时，男性与生存率的提高相关（OR 1.34, 95% CI 1.01至1.78），但不再与神经预后相关（OR 1.24, 95% CI 0.92至1.67）。不良事件很常见；女性更常出现低钾血症、低镁血症和需要输血的出血，而男性则更多出现肺炎。在假定心脏骤停患者的亚组分析（n = 1361）中，男性在入院时更常进行CAG(58%对50%，P = 0.02)，但在调整后的分析中，这一差异消失了。在逮捕原因、不良事件和结果方面存在性别差异。男性与生存独立相关，但与神经预后无关。
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). 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. 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. Gender differences exist regarding cause of arrest, adverse events and outcome. Male gender was independently associated with survival but not with neurological outcome.
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影响因子：
158.5
作者：
Nielsen, Niklas;Wettersley, Jorn;Friberg, Hans
通讯作者：
Friberg, Hans
影响因子：
5.7
作者：
Adielsson, Anna;Hollenberg, Jacob;Herlitz, Johan
通讯作者：
Herlitz, Johan
影响因子：
6.3
作者：
Nante, N.;Messina, G.;McKee, M.
通讯作者：
McKee, M.
影响因子：
6.5
作者：
Herlitz, J;Engdahl, J;Holmberg, S
通讯作者：
Holmberg, S
影响因子：
8.8
作者：
Nielsen, Niklas;Sunde, Kjetil;Friberg, Hans
通讯作者：
Friberg, Hans