Reduction in incidence and fatality of out-of-hospital cardiac arrest in females of the reproductive age

Kitamura, Tetsuhisa; Iwami, Taku; Nichol, Graham; Nishiuchi, Tatsuya; Hayashi, Yasuyuki; Nishiyama, Chika; Sakai, Tomohiko; Kajino, Kentaro; Hiraide, Atsushi; Ikeuchi, Hisashi; Nonogi, Hiroshi; Kawamura, Takashi

doi:10.1093/eurheartj/ehq059

Cited by 84 publications

(95 citation statements)

References 34 publications

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“…43 Women, on the other hand, are more likely to survive during reproductive years. 8,23,26,30 This advantage disappears in a linear fashion as they age. 10,11 Women have increased chest wall compliance and disparities in pharmacobiology, making it easier to resuscitate them.…”

Section: Discussionmentioning

confidence: 99%

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Differential Survival for Men and Women from Out-of-hospital Cardiac Arrest Varies by Age: Results from the OPALS Study

et al. 2014

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Section: Discussionmentioning

confidence: 99%

“…Four show a survival advantage in younger women. 8,23,26,30 However, the same interaction has not been tested across the age spectrum for men.…”

Section: Academic Emergency Medicinementioning

confidence: 99%

Differential Survival for Men and Women from Out-of-hospital Cardiac Arrest Varies by Age: Results from the OPALS Study

et al. 2014

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“…[2][3][4][5][6][7][8][9][10] Kitamura and his group has demonstrated that women aged 13-49 years had a significantly lower incidence and a better outcome after OHCA compared to men in the same age cohort. 9 Topjian et al, 8 who studied in-hospital cardiac arrest has shown that women of child-bearing age (15-44 years of age) were more likely to survive to hospital discharge than men. 8 Both groups have speculated that this difference might be explained by potential cardioprotective effects of female sex hormones 8,9 and our results lend further support to that speculation.…”

Section: Discussionmentioning

confidence: 99%

“…9 Topjian et al, 8 who studied in-hospital cardiac arrest has shown that women of child-bearing age (15-44 years of age) were more likely to survive to hospital discharge than men. 8 Both groups have speculated that this difference might be explained by potential cardioprotective effects of female sex hormones 8,9 and our results lend further support to that speculation. Although the epidemiology and outcomes from OHCA and inhospital cardiac arrest differ, improved survival outcomes for women in the child-bearing age group is a consistent finding across the studies.…”

Section: Discussionmentioning

confidence: 99%

“…1 Certain medical conditions/diseases have gender 1 -based predominance due to specific hormonal regulation. [2][3][4][5][6][7][8][9][10] Furthermore gender disparities in access to care have been observed previously at many different levels of care, including primary, acute and chronic care. [11][12][13][14][15][16][17][18][19][20][21] For example, women are more likely to have a diagnosis of myocardial infarction missed in the Emergency Department, and are less likely to receive invasive diagnostic testing and treatments for cardiovascular diseases, such as cardiac catheterization and percutaneous coronary intervention -all of which might account for poorer outcomes and increased mortality.…”

Section: Introductionmentioning

confidence: 99%

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Effect of Gender on Outcome of Out of Hospital Cardiac Arrest in the Resuscitation Outcomes Consortium

Eastley

2016

The Journal of Emergency Medicine

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Sex- and Age-Based Disparities in Public Access Defibrillation, Bystander Cardiopulmonary Resuscitation, and Neurological Outcome in Cardiac Arrest

et al. 2023

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ImportanceYounger females with out-of-hospital cardiac arrest (OHCA) in public locations have less likelihood to receive public access defibrillation and bystander cardiopulmonary resuscitation (CPR). However, the association between age- and sex-based disparities and neurological outcomes remains underexamined.ObjectiveTo investigate the association between sex and age and the rate of receiving bystander CPR, automated external defibrillator defibrillation, and neurological outcomes in patients with OHCA.Design, Setting, and ParticipantsThis cohort study used the All-Japan Utstein Registry, a prospective, population-based, nationwide database in Japan containing data on 1 930 273 patients with OHCA between January 1, 2005, and December 31, 2020. The cohort comprised patients with OHCA of cardiac origin that was witnessed by citizens and treated by emergency medical service personnel. The data were analyzed from September 3, 2022, to May 5, 2023.ExposureSex and age.Main Outcomes and MeasuresThe primary outcome was favorable neurological outcome at 30 days after an OHCA. Favorable neurological outcome was defined as a Cerebral Performance Category score of 1 (indicating good cerebral performance) or 2 (indicating moderate cerebral disability). The secondary outcomes were the rates of receiving public access defibrillation and bystander CPR.ResultsThe 354 409 included patients who experienced bystander-witnessed OHCA of cardiac origin had a median (IQR) age of 78 (67-86) years and 136 520 were females (38.5%). The rate of receiving public access defibrillation was higher in males than females (3.2% vs 1.5%; P &lt; .001). Stratified by age, age- and sex-based disparities in prehospital lifesaving interventions by bystanders and in neurological outcomes were observed. Although younger females had a lower rate of receiving public access defibrillation and bystander CPR than males, younger females had a higher favorable neurological outcome compared with males of the same age (odds ratio [OR], 1.19; 95% CI, 1.08-1.31). In younger females with OHCA that was witnessed by nonfamily bystanders, receiving public access defibrillation (OR, 3.51; 95% CI, 2.34-5.27) or bystander CPR (OR, 1.62; 95% CI, 1.20-2.22) was associated with a favorable neurological outcome.Conclusions and RelevanceResults of this study suggest a pattern of significant sex- and age-based differences in bystander CPR, public access defibrillation, and neurological outcomes in Japan. Improvement in neurological outcomes in patients with OHCA, especially younger females, was associated with increased use of public access defibrillation and bystander CPR.

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Reduction in incidence and fatality of out-of-hospital cardiac arrest in females of the reproductive age

Abstract: Reproductive females had a lower incidence and a better outcome of OHCA than females of other ages and males, which might be explained by cardioprotective effects of endogenous oestrogen on OHCA.

Cited by 84 publications

References 34 publications

Differential Survival for Men and Women from Out-of-hospital Cardiac Arrest Varies by Age: Results from the OPALS Study

Differential Survival for Men and Women from Out-of-hospital Cardiac Arrest Varies by Age: Results from the OPALS Study

Effect of Gender on Outcome of Out of Hospital Cardiac Arrest in the Resuscitation Outcomes Consortium

Sex- and Age-Based Disparities in Public Access Defibrillation, Bystander Cardiopulmonary Resuscitation, and Neurological Outcome in Cardiac Arrest

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