Pell J P, Sirel J, Marsden A K, Cobbe S M
Department of Public Health Medicine, Greater Glasgow Health Board, Glasgow, UK.
Eur Heart J. 2000 Feb;21(3):239-44. doi: 10.1053/euhj.1999.1629.
To determine whether men and women suffering cardiopulmonary arrest differ in terms of survival and risk factors for survival.
A prospective cohort study, using the Heartstart (Scotland) database, was undertaken on all 22 161 people suffering community-based cardiopulmonary arrest in Scotland between 1988 and 1997. The outcomes studied were death at the arrest scene, death before admission, death in hospital and death at any point up to discharge. Univariate analysis, using chi-square and Mann-Whitney U tests, was used to compare men and women in terms of patient characteristics, management and outcome. Multivariate logistic regression analysis was used to determine the association between sex and outcome after adjustment for case-mix. Sex differences in outcome varied over time. Women had a poorer risk profile than men. They were older (P<0.0001) and less likely to have shockable rhythms (P<0.0001). Despite this, they were more likely to survive to admission (P<0.0001). However, thereafter, women were more likely to die in hospital (P<0.01). There was no significant difference between the sexes in overall case-fatality rates to discharge.
Women have a better early prognosis than men. However, this represents a postponement of death, rather than avoidance.
确定心脏骤停的男性和女性在生存率及生存风险因素方面是否存在差异。
采用前瞻性队列研究，利用Heartstart（苏格兰）数据库，对1988年至1997年间苏格兰所有22161例发生在社区的心脏骤停患者进行研究。研究的结局包括在骤停现场死亡、入院前死亡、在医院死亡以及直至出院任何时间点的死亡。使用卡方检验和曼-惠特尼U检验进行单因素分析，以比较男性和女性在患者特征、治疗及结局方面的差异。多因素逻辑回归分析用于在调整病例组合后确定性别与结局之间的关联。结局的性别差异随时间而变化。女性的风险状况比男性差。她们年龄更大（P<0.0001），发生可电击心律的可能性更小（P<0.0001）。尽管如此，她们更有可能存活至入院（P<0.0001）。然而，此后，女性在医院死亡的可能性更大（P<0.01）。至出院时的总体病死率在性别之间无显著差异。
女性早期预后比男性好。然而，这只是死亡的推迟，而非避免。
