• Resuscitation · Dec 2021

    Women receive less targeted temperature management than men following out-of-hospital cardiac arrest due to early care limitations - A study from the CARES Investigators.

    • Nicholas A Morris, Michael Mazzeffi, Patrick McArdle, Teresa L May, James F Burke, Steven M Bradley, Sachin Agarwal, Neeraj Badjatia, Sarah M Perman, and CARES Surveillance Group.
    • Department of Neurology, Program in Trauma, University of Maryland School of Medicine, Baltimore, MD, United States. Electronic address: nicholas.morris@som.umaryland.edu.
    • Resuscitation. 2021 Dec 1; 169: 97-104.

    BackgroundWomen experience worse neurological outcomes following out-of-hospital cardiac arrest (OHCA). It is unknown whether sex disparities exist in the use of targeted temperature management (TTM), a standard of care treatment to improve neurological outcomes.MethodsWe performed a retrospective study of prospectively collected patients who survived to hospital admission following OHCA from the Cardiac Arrest Registry to Enhance Survival from 2013 through 2019. We compared receipt of TTM by sex in a mixed-effects model adjusted for patient, arrest, neighborhood, and hospital factors, with the admitting hospital modeled as a random intercept.ResultsAmong 123,419 patients, women had lower rates of shockable rhythms (24.4 % vs. 39.2%, P < .001) and lower rates of presumed cardiac aetiologies for arrest (74.3% vs. 81.1%, P < .001). Despite receiving a similar rate of TTM in the field (12.1% vs. 12.6%, P = .02), women received less TTM than men upon admission to the hospital (41.6% vs. 46.4%, P < .001). In an adjusted mixed-effects model, women were less likely than men to receive TTM (Odds Ratio 0.91, 95% Confidence Interval 0.89 to 0.94). Among the 27,729 patients with data indicating the reason for not using TTM, a higher percentage of women did not receive TTM due to Do-Not-Resuscitate orders/family requests (15.1% vs. 11.4%, p < .001) and non-shockable rhythms (11.1% vs. 8.4%, p < .001).ConclusionsWe found that women received less TTM than men, likely due to early care limitations and a preponderance of non-shockable rhythms.Copyright © 2021 Elsevier B.V. All rights reserved.

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