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Emerg Med Australas · Apr 2023
Sex differences among patients presenting to hospital with out-of-hospital cardiac arrest and shockable rhythm.
- Felicia Cs Ho, Wayne C Zheng, Samer Noaman, Riley J Batchelor, Noah Wexler, Laura Hanson, Jason E Bloom, Omar Al-Mukhtar, Kawa Haji, Nicholas D'Elia, David Kaye, James Shaw, Yang Yang, Craig French, Dion Stub, Nicholas Cox, and William Chan.
- Department of Cardiology, Western Health, Melbourne, Victoria, Australia.
- Emerg Med Australas. 2023 Apr 1; 35 (2): 297305297-305.
ObjectiveSex differences in patients presenting with out-of-hospital cardiac arrest (OHCA) and shockable rhythm might be associated with disparities in clinical outcomes.MethodsWe conducted a retrospective cohort study and compared characteristics and short-term outcomes between male and female adult patients who presented with OHCA and shockable rhythm at two large metropolitan health services in Melbourne, Australia between the period of 2014-2018. Logistic regression was used to assess the effect of sex on clinical outcomes.ResultsOf 212 patients, 166 (78%) were males and 46 (22%) were females. Both males and females presented with similar rates of ST-elevation myocardial infarction (44% vs 36%, P = 0.29), although males were more likely to have a history of coronary artery disease (32% vs 13%) and a final diagnosis of a cardiac cause for their OHCA (89% vs 72%), both P = 0.01. Rates of coronary angiography (81% vs 71%, P = 0.23) and percutaneous coronary intervention (51% vs 42%, P = 0.37) were comparable among males and females. No differences in rates of in-hospital mortality (38% vs 37%, P = 0.90) and 30-day major adverse cardiac and cerebrovascular events (composite of all-cause mortality, myocardial infarction, coronary revascularization and nonfatal stroke) (39% vs 41%, P = 0.79) were observed between males and females, respectively. Female sex was not associated with worse in-hospital mortality when adjusted for other variables (odds ratio 0.66, 95% confidence interval 0.28-1.60, P = 0.36).ConclusionAmong patients presenting with OHCA and a shockable rhythm, baseline sex and sex differences were not associated with disparities in short-term outcomes in contemporary systems of care.© 2022 The Authors. Emergency Medicine Australasia published by John Wiley & Sons Australia, Ltd on behalf of Australasian College for Emergency Medicine.
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