Associations between gender and cardiac arrest outcomes in Pan-Asian out-of-hospital cardiac arrest patients

PAROS Clinical Research Network

Research output: Contribution to journalArticle

19 Citations (Scopus)

Abstract

Background: The incidence of out-of-hospital cardiac arrest (OHCA) in women is thought to be lower than that of men, with better outcomes in some Western studies. Objectives: This study aimed to investigate the effect of gender on OHCA outcomes in the Pan-Asian population. Methodology: This was a retrospective, secondary analysis of the Pan Asian Resuscitation Outcomes Study (PAROS) data between 2009 and 2012. We included OHCA cases which were presumed cardiac etiology, aged 18 years and above and resuscitation attempted by emergency medical services (EMS) systems. We used multi-level mixed-effects logistic regression models to account for the clustering effect of individuals within the country. Primary outcome was survival to hospital discharge. Results: We included a total of 40,159 OHCA cases, 40% of which were women. We found that women were more likely to be older and have an initial non-shockable arrest rhythm; they were more likely to receive bystander cardio-pulmonary resuscitation (CPR). The univariate analysis showed that women were significantly less likely to have return of spontaneous circulation (ROSC) at scene or in the emergency department (ED), and had lower rates of survival-to-admission and discharge, and poorer overall and cerebral performance outcomes. There was however, no significant gender difference on outcomes after adjustment of other confounders. Women in the reproductive age group (age 18-44 years) were significantly more likely to have ROSC at scene or in the ED, higher rates of survival-to-admission and discharge, and have better overall and cerebral performance outcomes after adjustment for differences in baseline and pre-hospital factors. Menopausal women (age 55 years and above) were less likely to survive to admission after adjusting for other pre-hospital characteristics but not after age adjustment. Conclusion: Differences in survival outcomes between reproductive and menopausal women highlight a need for further investigations into the plausible social, pathologic or hormonal basis.

Original languageEnglish
Pages (from-to)116-121
Number of pages6
JournalResuscitation
Volume102
DOIs
Publication statusPublished - 2016 May 1

Fingerprint

Out-of-Hospital Cardiac Arrest
Heart Arrest
Resuscitation
Hospital Emergency Service
Survival Rate
Logistic Models
Survival
Cardiopulmonary Resuscitation
Emergency Medical Services
Cluster Analysis
Age Groups
Outcome Assessment (Health Care)
Incidence

All Science Journal Classification (ASJC) codes

  • Emergency Medicine
  • Emergency
  • Cardiology and Cardiovascular Medicine

Cite this

@article{ab4c3faba7ba4f3db9bf4ade11c7c02b,
title = "Associations between gender and cardiac arrest outcomes in Pan-Asian out-of-hospital cardiac arrest patients",
abstract = "Background: The incidence of out-of-hospital cardiac arrest (OHCA) in women is thought to be lower than that of men, with better outcomes in some Western studies. Objectives: This study aimed to investigate the effect of gender on OHCA outcomes in the Pan-Asian population. Methodology: This was a retrospective, secondary analysis of the Pan Asian Resuscitation Outcomes Study (PAROS) data between 2009 and 2012. We included OHCA cases which were presumed cardiac etiology, aged 18 years and above and resuscitation attempted by emergency medical services (EMS) systems. We used multi-level mixed-effects logistic regression models to account for the clustering effect of individuals within the country. Primary outcome was survival to hospital discharge. Results: We included a total of 40,159 OHCA cases, 40{\%} of which were women. We found that women were more likely to be older and have an initial non-shockable arrest rhythm; they were more likely to receive bystander cardio-pulmonary resuscitation (CPR). The univariate analysis showed that women were significantly less likely to have return of spontaneous circulation (ROSC) at scene or in the emergency department (ED), and had lower rates of survival-to-admission and discharge, and poorer overall and cerebral performance outcomes. There was however, no significant gender difference on outcomes after adjustment of other confounders. Women in the reproductive age group (age 18-44 years) were significantly more likely to have ROSC at scene or in the ED, higher rates of survival-to-admission and discharge, and have better overall and cerebral performance outcomes after adjustment for differences in baseline and pre-hospital factors. Menopausal women (age 55 years and above) were less likely to survive to admission after adjusting for other pre-hospital characteristics but not after age adjustment. Conclusion: Differences in survival outcomes between reproductive and menopausal women highlight a need for further investigations into the plausible social, pathologic or hormonal basis.",
author = "{PAROS Clinical Research Network} and Ng, {Yih Yng} and Win Wah and Nan Liu and Zhou, {Sheng Ang} and Ho, {Andrew Fu Wah} and Pek, {Pin Pin} and Shin, {Sang Do} and Hideharu Tanaka and Nalinas Khunkhlai and Lin, {Chih Hao} and Wong, {Kwanhathai Darin} and Cai, {Wen Wei} and Ong, {Marcus Eng Hock} and Ma, {M. H.M.} and Koh, {P. C.I.} and T. Nishiuchi and T. Nakagawa and Lee, {E. J.} and Ryoo, {H. W.} and Song, {K. J.} and Hisamud-din, {N. A.R.} and Karim, {S. A.} and Naroo, {G. Y.} and Omer, {A. S.} and T. Yagdir and P. Khruekarnchana and A. Monsomboon and T. Piyasuwankul and Goh, {E. S.} and Mao, {D. R.H.} and Doctor, {N. E.} and Tham, {L. P.} and K. Kajino and Charles, {R. A.} and Cheah, {S. O.} and Foo, {D. C.G.} and Chia, {M. Y.C.} and Gan, {H. N.}",
year = "2016",
month = "5",
day = "1",
doi = "10.1016/j.resuscitation.2016.03.002",
language = "English",
volume = "102",
pages = "116--121",
journal = "Resuscitation",
issn = "0300-9572",
publisher = "Elsevier Ireland Ltd",

}

Associations between gender and cardiac arrest outcomes in Pan-Asian out-of-hospital cardiac arrest patients. / PAROS Clinical Research Network.

In: Resuscitation, Vol. 102, 01.05.2016, p. 116-121.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Associations between gender and cardiac arrest outcomes in Pan-Asian out-of-hospital cardiac arrest patients

AU - PAROS Clinical Research Network

AU - Ng, Yih Yng

AU - Wah, Win

AU - Liu, Nan

AU - Zhou, Sheng Ang

AU - Ho, Andrew Fu Wah

AU - Pek, Pin Pin

AU - Shin, Sang Do

AU - Tanaka, Hideharu

AU - Khunkhlai, Nalinas

AU - Lin, Chih Hao

AU - Wong, Kwanhathai Darin

AU - Cai, Wen Wei

AU - Ong, Marcus Eng Hock

AU - Ma, M. H.M.

AU - Koh, P. C.I.

AU - Nishiuchi, T.

AU - Nakagawa, T.

AU - Lee, E. J.

AU - Ryoo, H. W.

AU - Song, K. J.

AU - Hisamud-din, N. A.R.

AU - Karim, S. A.

AU - Naroo, G. Y.

AU - Omer, A. S.

AU - Yagdir, T.

AU - Khruekarnchana, P.

AU - Monsomboon, A.

AU - Piyasuwankul, T.

AU - Goh, E. S.

AU - Mao, D. R.H.

AU - Doctor, N. E.

AU - Tham, L. P.

AU - Kajino, K.

AU - Charles, R. A.

AU - Cheah, S. O.

AU - Foo, D. C.G.

AU - Chia, M. Y.C.

AU - Gan, H. N.

PY - 2016/5/1

Y1 - 2016/5/1

N2 - Background: The incidence of out-of-hospital cardiac arrest (OHCA) in women is thought to be lower than that of men, with better outcomes in some Western studies. Objectives: This study aimed to investigate the effect of gender on OHCA outcomes in the Pan-Asian population. Methodology: This was a retrospective, secondary analysis of the Pan Asian Resuscitation Outcomes Study (PAROS) data between 2009 and 2012. We included OHCA cases which were presumed cardiac etiology, aged 18 years and above and resuscitation attempted by emergency medical services (EMS) systems. We used multi-level mixed-effects logistic regression models to account for the clustering effect of individuals within the country. Primary outcome was survival to hospital discharge. Results: We included a total of 40,159 OHCA cases, 40% of which were women. We found that women were more likely to be older and have an initial non-shockable arrest rhythm; they were more likely to receive bystander cardio-pulmonary resuscitation (CPR). The univariate analysis showed that women were significantly less likely to have return of spontaneous circulation (ROSC) at scene or in the emergency department (ED), and had lower rates of survival-to-admission and discharge, and poorer overall and cerebral performance outcomes. There was however, no significant gender difference on outcomes after adjustment of other confounders. Women in the reproductive age group (age 18-44 years) were significantly more likely to have ROSC at scene or in the ED, higher rates of survival-to-admission and discharge, and have better overall and cerebral performance outcomes after adjustment for differences in baseline and pre-hospital factors. Menopausal women (age 55 years and above) were less likely to survive to admission after adjusting for other pre-hospital characteristics but not after age adjustment. Conclusion: Differences in survival outcomes between reproductive and menopausal women highlight a need for further investigations into the plausible social, pathologic or hormonal basis.

AB - Background: The incidence of out-of-hospital cardiac arrest (OHCA) in women is thought to be lower than that of men, with better outcomes in some Western studies. Objectives: This study aimed to investigate the effect of gender on OHCA outcomes in the Pan-Asian population. Methodology: This was a retrospective, secondary analysis of the Pan Asian Resuscitation Outcomes Study (PAROS) data between 2009 and 2012. We included OHCA cases which were presumed cardiac etiology, aged 18 years and above and resuscitation attempted by emergency medical services (EMS) systems. We used multi-level mixed-effects logistic regression models to account for the clustering effect of individuals within the country. Primary outcome was survival to hospital discharge. Results: We included a total of 40,159 OHCA cases, 40% of which were women. We found that women were more likely to be older and have an initial non-shockable arrest rhythm; they were more likely to receive bystander cardio-pulmonary resuscitation (CPR). The univariate analysis showed that women were significantly less likely to have return of spontaneous circulation (ROSC) at scene or in the emergency department (ED), and had lower rates of survival-to-admission and discharge, and poorer overall and cerebral performance outcomes. There was however, no significant gender difference on outcomes after adjustment of other confounders. Women in the reproductive age group (age 18-44 years) were significantly more likely to have ROSC at scene or in the ED, higher rates of survival-to-admission and discharge, and have better overall and cerebral performance outcomes after adjustment for differences in baseline and pre-hospital factors. Menopausal women (age 55 years and above) were less likely to survive to admission after adjusting for other pre-hospital characteristics but not after age adjustment. Conclusion: Differences in survival outcomes between reproductive and menopausal women highlight a need for further investigations into the plausible social, pathologic or hormonal basis.

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U2 - 10.1016/j.resuscitation.2016.03.002

DO - 10.1016/j.resuscitation.2016.03.002

M3 - Article

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VL - 102

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EP - 121

JO - Resuscitation

JF - Resuscitation

SN - 0300-9572

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