Sex disparity in resuscitation efforts and outcomes in out-of-hospital cardiac arrest
Sex disparity in resuscitation efforts and outcomes in out-of-hospital cardiac arrest
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DOI：
10.1016/j.ajem.2012.02.018
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发表时间：
2012-11-01
影响因子：
3.6
通讯作者：
Hwang, Seung Sik
中科院分区：
文献类型：
--
作者：
Ahn, Ki Ok;Shin, Sang Do;Hwang, Seung Sik
目的：本研究的目的是调查性别，心肺复苏努力，院外心脏骤停在Korea.Methods的结果之间的关联：我们使用了一个全国性的，院外心脏骤停队列数据库在2008年。我们提取的病例涉及年龄大于20岁的患者的症状推定的心脏病因。使用Utstein风格收集潜在的预测因子。主要结局是复苏努力：急救医疗服务提供者的基本生命支持和自动体外除颤器的应用，以及急诊科医生的高级心脏生命支持。次要结局为入院生存率和出院生存率。单变量和多变量Logistic回归模型应用性别来计算比值比和95%的可信区间调整潜在predictors.Results：符合条件的患者总数为13 922。其中，5158例患者（37.0%）为女性。女性接受基本生命支持（70.8% vs 77.5%，P < .001）或自动体外除颤器（9.6% vs 14.3%，P < .001）或接受高级心脏生命支持（42.2% vs 49.2%，P < .001）的可能性也低于男性。与男性相比，女性的入院和出院生存率分别为11.8%（vs12.3%，P = 0.43）和3.1%（vs1.8%，P <0.001）。与男性相比，女性入院生存率和出院生存率的校正比值比分别为1.32（1.17-1.48）和0.82（0.63-1.05）。女性与入院时较高的生存率相关，而与出院时的生存率无关。(C)2012 Elsevier Inc. All rights reserved.
Objectives: The aim of this study was to investigate the association between sex, cardiopulmonary resuscitation efforts, and outcomes of out-of-hospital cardiac arrests in Korea.Methods: We used a nationwide, out-of-hospital cardiac arrest cohort database in 2008. We extracted cases involving patients older than 20 years with symptoms of presumed cardiac etiology. Potential predictors were collected using the Utstein style. The primary outcome was the resuscitation effort: basic life support and application of an automatic external defibrillator by emergency medical service providers, and advanced cardiac life support by emergency department physicians. Secondary outcomes were survival to admission and survival to discharge. Univariate and multivariate logistic regression models were applied by sex to calculate odds ratios and 95% confidence intervals adjusting for potential predictors.Results: The total number of eligible patients was 13 922. Of these, 5158 patients (37.0%) were female. Females were also less likely than males to receive basic life support (70.8% vs 77.5%, P < .001) or an automatic external defibrillator (9.6% vs 14.3%, P < .001), or receive advanced cardiac life support (42.2% vs 49.2%, P < .001). When compared with males, rates of survival to admission and discharge for females were 11.8% (vs 12.3%, P = .43) and 3.1% (vs 1.8%, P < .001), respectively. Adjusted odds ratios for survival to admission and survival to discharge for females, when compared with males, were 1.32 (1.17-1.48) and 0.82 (0.63-1.05), respectively.Conclusions: Females were less likely than males to receive resuscitation. Female sex was associated with a higher rate of survival at admission rate, whereas it was not associated with survival at discharge. (C) 2012 Elsevier Inc. All rights reserved.