Women of child-bearing age have better inhospital cardiac arrest survival outcomes than do equal-aged men.
Women of child-bearing age have better inhospital cardiac arrest survival outcomes than do equal-aged men.
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育龄的妇女比同龄男人更好的室内心脏骤停生存结果。
DOI：
10.1097/ccm.0b013e3181d8ca43
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发表时间：
2010-05
影响因子：
8.8
通讯作者：
American Heart Association National Registry of Cardiopulmonary Resuscitation Investigators
中科院分区：
文献类型：
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作者：
Topjian AA;Localio AR;Berg RA;Alessandrini EA;Meaney PA;Pepe PE;Larkin GL;Peberdy MA;Becker LB;Nadkarni VM;American Heart Association National Registry of Cardiopulmonary Resuscitation Investigators
雌激素和黄体酮改善心脏骤停和中风实验模型的神经学结果。我们的目标是确定育龄女性是否比男性更有可能在住院期间心脏骤停后存活到出院。前瞻性、观察性研究519家医院在国家CPR数据库中登记了95,852名男性和女性，年龄在15-44岁，≥为56岁，从01年1月1日到2008年7月31日，有无脉搏骤停的患者按性别和年龄组(15-44岁和≥56岁)进行了先验分层。采用医院固定效应回归条件处理，检验年龄、性别与生存结局的关系。年轻育龄女性(15-44岁)的未调整存活率为19%(940/4887)，而年轻男性为17%(1203/7025)(p=.013)。这些年轻女性和男性之间调整后的出院差异为2.8%(95%CI，1.0%-4.6%；p=.002)，这些年轻女性在良好的神经预后方面也有2.6%(95%CI，0.9%-4.3%；p=0.002)的绝对增加。对于老年女性和男性(≥56岁)，在放电率(18%对18%，调整后差异-0.1%；95%CI，-0.9%-+0.6%；p=.68)或良好的神经结果(14%对14%，调整后差异-0.1%；95%CI，-0.7%-+0.5%；p=.74)方面没有明显差异。即使在控制了心跳骤停的病因和其他重要变量后，育龄女性比同等年龄的男性更有可能在住院期间心脏骤停后存活到出院。
Estrogen and progesterone improve neurologic outcomes in experimental models of cardiac arrest and stroke. Our objective was to determine whether women of child-bearing age are more likely than men to survive to hospital discharge following in-hospital cardiac arrest. Prospective, observational study 519 hospitals in the National Registry of CPR database 95,852 men and women 15-44 years and ≥56 years with pulseless cardiac arrests from 01/01/00 through 07/31/08 Patients were stratified a priori by sex and age groups (15-44 years and ≥56 years). Fixed effects regression conditioning on hospital was used to examine the relationship between age, sex and survival outcomes. The unadjusted survival to discharge rate for younger women of child bearing age (15-44 years of age) was 19% (940/4887) versus 17% (1203/7025) for younger men (p=.013). The adjusted hospital discharge difference between these younger women and men was 2.8% (95% CI, 1.0%-4.6%; p=.002) and these younger women also had a 2.6% (95% CI, 0.9% - 4.3%; p=.002) absolute increase in favorable neurologic outcome. For older women compared with men (≥56 years), there were no demonstrable differences in discharge rates (18% versus 18%, adjusted difference -0.1%; 95% CI, -0.9% - +0.6%; p=.68) or favorable neurologic outcome (14% versus 14%, adjusted difference -0.1%; 95% CI, -0.7% - +0.5%; p=.74). Women of child-bearing age were more likely than comparably aged men to survive to hospital discharge following in-hospital cardiac arrest, even after controlling for etiology of arrest and other important variables.