• Am J Emerg Med · Nov 2022

    Sex disparities in prehospital advanced cardiac life support in out-of-hospital cardiac arrests in Japan.

    • Sanae Hosomi, Ling Zha, Kosuke Kiyohara, Tetsuhisa Kitamura, Taro Irisawa, Hiroshi Ogura, and Jun Oda.
    • Department of Traumatology and Acute Critical Medicine, Osaka University Graduate School of Medicine, Japan; Division of Environmental Medicine and Population Sciences, Department of Social Medicine, Graduate School of Medicine, Osaka University, Japan. Electronic address: s-hosomi@hp-emerg.med.osaka-u.ac.jp.
    • Am J Emerg Med. 2022 Nov 22; 64: 677367-73.

    ObjectiveSex disparities in out-of-hospital cardiac arrest (OHCA) care processes have been reported. This study aimed to investigate the association between sex and prehospital advanced cardiac life support (ACLS) interventions provided by emergency medical services in Japan.MethodsWe analyzed data from January 1, 2013, to December 31, 2020, from the All-Japan Utstein Registry of patients with OHCA aged ≥18 years who were resuscitated by bystanders. The primary outcomes were prehospital ACLS interventions, including advanced airway management (AAM) and epinephrine administration. Sex-based disparities in receiving prehospital ACLS interventions were assessed via multivariable logistic regression analyses.ResultsAmong 314,460 eligible patients, females with OHCA received fewer prehospital ACLS interventions than males: 83,571/187,834 (44.5%) males vs. 55,086/126,626 (43.5%) females (adjusted odds ratio [AOR] = 0.94, 95% confidence interval [CI] = 0.93-0.96) for AAM and 60,097/187,834 (32.0%) males vs. 35,501/126,626 (28.0%) females (AOR = 0.84, 95% CI = 0.83-0.85) for epinephrine administration. Similar results were also obtained in the subgroup analysis (groups included patients aged 18-74 years and ≥75 years and those with cardiac origin, ventricular fibrillation (VF), non-VF, non-family member witnessed, and family member witnessed).ConclusionCompared with males, females were less likely to receive prehospital ACLS. Emergency medical service staff must be made aware of this disparity, and off-the-job training on intravenous cannulation or AAM replacement must be conducted. Investigation of the impact of sex disparity on OHCA care processes can facilitate planning of future public health policies to improve survival outcomes.Copyright © 2022 Elsevier Inc. All rights reserved.

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