Sex and 30-day survival following out-of-hospital cardiac arrest in Scotland 2011-2020.

IF 2 Q2 EMERGENCY MEDICINE

International Journal of Emergency Medicine Pub Date : 2024-10-07 DOI:10.1186/s12245-024-00731-0

Laura A E Bijman, Sarah H Wild, Gareth Clegg, Nynke Halbesma

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引用次数: 0

Abstract

Background: Differences in 30-day survival between males and females following out-of-hospital cardiac arrest (OHCA) are well documented. Biological sex does not appear to be responsible for this survival gap independently of potential mediating factors. We investigated the role of potential mediating factors in the association between sex and 30-day survival after OHCA in Scotland.

Methods: A retrospective cohort study of adult non-emergency medical services (EMS)-witnessed OHCA cases was conducted. We included incidents from the whole of Scotland where resuscitation was attempted by the Scottish Ambulance Service (SAS) between April 1, 2011 and March 1, 2020. Logistic regression was used to assess the contribution of age, socioeconomic status, urban-rural location of the incident, initial cardiac rhythm, bystander cardiopulmonary resuscitation (CPR) and location of the arrest (home or away from home).

Results: The cohort consisted of 20,585 OHCA cases (13,130 males and 7,455 females). Median (IQR) age was 69 years (22) for males versus 72 years (23) for females. A higher proportion of males presented with initial shockable rhythm (29.4% versus 12.4%) and received bystander CPR (56.7% versus 53.2%) compared with females. A higher proportion of females experienced OHCA at home (78.8% versus 66.8%). Thirty-day survival after OHCA was higher for males compared with females (8.2% versus 6.2%). Males had higher age-adjusted odds for 30-day survival after OHCA than females (OR, 1.26; (95% CI), 1.12-1.41). Mediation analyses suggested a role for initial cardiac rhythm and location of the arrest (home or away from home).

Conclusion: Males had higher age-adjusted 30-day survival after OHCA than females. However, after adjusting for confounding/mediating variables, sex was not associated with 30-day survival after OHCA. Our findings suggest that initial cardiac rhythm and location of the arrest are potential mediators of higher 30-day OHCA survival in males than females. Improving proportions of females who present with initial shockable rhythm may reduce sex differences in survival after OHCA.

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2011-2020 年苏格兰院外心脏骤停患者的性别和 30 天存活率。

背景：院外心脏骤停（OHCA）后，男性和女性的 30 天存活率存在差异，这一点有据可查。除了潜在的中介因素外，生理性别似乎并不是造成这种存活率差距的原因。我们研究了苏格兰院外心脏骤停患者性别与 30 天存活率之间潜在中介因素的作用：我们对非紧急医疗服务（EMS）目击的成人 OHCA 病例进行了回顾性队列研究。我们纳入了 2011 年 4 月 1 日至 2020 年 3 月 1 日期间苏格兰救护服务机构（SAS）在全苏格兰尝试进行复苏的事件。我们使用逻辑回归法评估了年龄、社会经济地位、事件发生地的城乡差异、初始心律、旁观者心肺复苏（CPR）和停搏地点（在家或离家）等因素的影响：队列中有 20,585 例 OHCA（男性 13,130 例，女性 7,455 例）。男性的中位（IQR）年龄为 69 岁（22），女性为 72 岁（23）。与女性相比，男性出现初始可电击心律（29.4% 对 12.4%）和接受旁观者心肺复苏（56.7% 对 53.2%）的比例更高。在家中发生 OHCA 的女性比例更高（78.8% 对 66.8%）。与女性相比，男性在发生 OHCA 后的 30 天存活率更高（8.2% 对 6.2%）。经年龄调整后，男性在 OHCA 后 30 天存活率高于女性（OR，1.26；（95% CI），1.12-1.41）。中介分析表明，最初的心律和心跳骤停的地点（在家或离家）起了作用：结论：经年龄调整后，男性在心脏骤停后30天的存活率高于女性。然而，在对混杂/中介变量进行调整后，性别与 OHCA 后的 30 天存活率无关。我们的研究结果表明，最初的心律和心跳骤停的位置是导致男性 OHCA 30 天存活率高于女性的潜在因素。提高初始心律可电击的女性比例可能会缩小 OHCA 后存活率的性别差异。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

International Journal of Emergency Medicine EMERGENCY MEDICINE-

CiteScore

4.60

自引率

0.00%

发文量

审稿时长

13 weeks

期刊介绍： The aim of the journal is to bring to light the various clinical advancements and research developments attained over the world and thus help the specialty forge ahead. It is directed towards physicians and medical personnel undergoing training or working within the field of Emergency Medicine. Medical students who are interested in pursuing a career in Emergency Medicine will also benefit from the journal. This is particularly useful for trainees in countries where the specialty is still in its infancy. Disciplines covered will include interesting clinical cases, the latest evidence-based practice and research developments in Emergency medicine including emergency pediatrics.