Gender Disparities in Out-of-hospital Cardiac Arrests

Abstract

BackgroundDespite advances in resuscitation science and public health, out-of-hospital cardiac arrest (OOHCA) has an average survival rate of only 12% nationwide, compared to 24.8% of patients who suffer from cardiac arrest while in hospital. Additionally, gender is an important element of human health, and there is a clear pattern for gender-specific survivability in cardiac arrest. This study examined differences in presentations, treatment, management, and outcomes.AimThe primary focus of this study was to shed light on differences in presentations, treatments, and outcomes between men and women suffering from an out-of-hospital cardiac arrest and the accompanying contributing factors.MethodsAll emergency medical services-related data, including age, date, initial rhythm, chemical interventions (i.e., epinephrine, dextrose), blood glucose levels, defibrillations, endotracheal tube (ETT) attempts, final airway management, achievement of return of spontaneous circulation (ROSC), and the conclusion of the case up to the emergency department, were recorded using a standardized emergency medical services (EMS) charting record by the highest-ranking EMS provider on the ambulance. The reports were retrospectively collected and analyzed.ConclusionThe study examined demographics, treatments rendered, and outcomes in OOHCA cases that occurred in a major United States (US) city in 2016. Several significant differences in care were noted between men and women. In general, women received less respiratory, chemical, and electrical interventions than men; however, statistically significant differences were only observed in the number of attempts of endotracheal intubations, number of doses of epinephrine per encounter, and number of defibrillations per encounter. In spite of generally receiving less care, women appeared to respond more favorably to cardiac arrest interventions, as demonstrated by higher rates of ROSC. Despite this, women were also found to be eight years older at the time of arrest. Future studies are needed to determine causality in discrepancies between the genders in addition to investigating differences in treatment in other areas of the United States.

Gender disparities among adult recipients of layperson bystander cardiopulmonary resuscitation by location of cardiac arrest in Pan-Asian communities: A registry-based study

“… 7 , 8 They were also more likely to get advanced life support or targeted interventions (e.g., epinephrine, advanced airway management). 26 , 27 These sex-related differences are associated with a disparity in patient outcomes. On the one hand, women were observed to have a better chance of surviving to hospital admission.…”

Development of Emergency Medical Services Amid 5 Years’ Experience at a Medical School in Thailand

“…By operating EMS under appropriate technology such as telehealth, it can reduce the delivery time of non-emergency patients to the hospital [2], and the development of a systematic database assists to develop an effective service model, for example, the use of Utstein to collect out-of-hospital cardiac arrest patients which has a format that is of international standard. It is possible to compare interagency or international EMS practice [3], [4], [5]. In addition, the timing or date of the operation should be analyzed as these factors influence the operations of EMS [6], [7], [8], [9], [10], [11].…”

Sex differences in patients with out-of-hospital cardiac arrest without ST-segment elevation: A COACT trial substudy

“…12,13,14,15 Studies including cardiac arrest patients with all initial rhythms and presumed cardiac aetiology have shown that almost 80% of patients are male 12,14,16,17,18 and that cardiac arrest due to an initial shockable rhythm is more common in men than women. 12,15,17,18,19 If women suffer from OHCA, they are often older 15,17,19,20 , and have a higher cardiovascular risk profile than men. 12,19 Present data on the association between sex and OHCA-related survival is mainly based on national registries containing a heterogeneous patient population.…”