Sex differences in outcome following community-based cardiopulmonary arrest

Abstract

Women have a better early prognosis than men. However, this represents a postponement of death, rather than avoidance.

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

“…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. High estrogen levels protect young women by lowering their low-density lipoprotein level and reducing their CAD risk.…”

“…46,47 Our study also confirms prior reports that despite an advantage earlier in life, overall survival in women is lower than in men. 8,10,[19][20][21][22][23][24] This could be because a majority (59%) of the cardiac arrests occurred between the ages of 65 and 85 years when men have a survival advantage over women. Also, women have fewer key prehospital factors that improve survival (witnessed arrest and shockable rhythms upon EMS arrival).…”

“…[8][9][10][11][12] However, data on survival to hospital discharge are conflicting. A majority show either no survival advantage 9,[12][13][14][15][16][17][18] or higher survival in men, 8,10,[19][20][21][22][23][24] while others indicate that women fare better. 18,25,26 Studies that report worse survival in women often attribute it to worse prehospital factors.…”

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

“…When survival across genders is adjusted for all the Utstein variables including the Utstein variables which favour survival and are more often reported in men, the difference in survival disappears. While some studies have demonstrated similar survival to hospital discharge outcomes, 3,4,31 others have reported lower survival to hospital discharge rates for women. 4,30,46 Pell et al, 4 and Perers et al, 30 concluded lower survival to discharge rates for women; however, they employed incomplete adjustment for all relevant Utstein variables.…”

“…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.…”