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Multicenter Study
Sex-related disparities in the in-hospital management of patients with out-of-hospital cardiac arrest.
- Juhyun Song, Sejoong Ahn, Jooyeong Kim, Hanjin Cho, Sungwoo Moon, Sung-Hyuk Choi, and Jong-Hak Park.
- Department of Emergency Medicine, Korea University Ansan Hospital, Ansan, Republic of Korea.
- Resuscitation. 2022 Apr 1; 173: 47-55.
AimWe investigated sex-related differences in the in-hospital management of patients with out-of-hospital cardiac arrest (OHCA).MethodsWe retrospectively analyzed prospectively collected data from the Korean Cardiac Arrest Resuscitation Consortium (KoCARC) registry, a prospective, multicenter OHCA registry. We enrolled adult patients with OHCA between October 2015 and June 2020. The primary outcomes were coronary angiography (CAG), percutaneous coronary intervention (PCI), targeted temperature management (TTM), and extracorporeal membrane oxygenation (ECMO) performed in the hospital. Propensity score matching (PSM) was performed to minimize differences in baseline demographics and characteristics.ResultsAmong 12,321 patients in the KoCARC registry, we analyzed 8,177 with OHCA. PSM yielded 5,564 matched patients (2,782 women and men, respectively). In the unmatched cohort, women were less likely to undergo CAG, PCI, TTM, and ECMO. In the PSM cohort, women were less likely to undergo CAG and PCI (6.4% vs. 9.1%, p < 0.001 and 1.9% vs. 3.7%, p < 0.001). The duration of cardiopulmonary resuscitation was shorter in women (19 vs. 20 min, p < 0.001). TTM, ECMO use, and survival outcomes did not differ significantly between sexes. The subgroup analysis according to age showed that among patients aged < 65 years, women were less likely than men to undergo CAG and PCI (12.7% vs. 19.2%, p < 0.001 and 2.3% vs. 8.1%, p < 0.001).ConclusionsIn the PSM cohort, women with OHCA underwent CAG and PCI less frequently than men, regardless of the initial rhythm. However, these sex-related differences narrowed with increasing age. Further studies are needed to confirm the sex-related disparities in the in-hospital management of patients with OHCA.Copyright © 2022 The Author(s). Published by Elsevier B.V. All rights reserved.
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