Herlitz Johan, Engdahl Johan, Svensson Leif, Young Marie, Angquist Karl-Axel, Holmberg Stig
Division of Cardiology, Sahlgrenska University Hospital, S-41345 Goteborg, Sweden.
Resuscitation. 2004 Feb;60(2):197-203. doi: 10.1016/j.resuscitation.2003.09.012.
To evaluate survival after out-of-hospital cardiac arrest in relation to sex.
All patients with out-of-hospital cardiac arrest included in the Swedish Cardiac Arrest Registry between 1990 and 2000 in whom cardiopulmonary resuscitation (CPR) was attempted and who did not have a crew witnessed arrest were included. The registry covers 85% of the inhabitants of Sweden (approximately 8 million inhabitants). P-values were adjusted to differences in age. Survival was defined as patients being hospitalised alive and being alive one month after cardiac arrest. In all, 23,797 patients participated in the survey of which 27.9% were women.
Among women 16.4% were hospitalised alive versus 13.2% among men ( P<0.001). After one month 3.0% among women were alive versus 3.4% among men (NS). In a multivariate analysis considering differences in age and various factors at resuscitation female sex was an independent predictor for patients being hospitalised alive (odds ratio 1.66; 95% confidence limits 1.49-1.84) and for being alive after one month (odds ratio 1.27; 95% confidence limits 1.03-1.56). Women differed from men as they were older ( P<0.001 ), had a lower prevalence of witnessed cardiac arrest ( P=0.01), a lower occurrence of bystander CPR (P<0.001), a lower occurrence of ventricular fibrillation as initial arrhythmia (P<0.001) and a lower occurrence of cardiac disease judged to be the cause of cardiac arrest ( P<0.0001 ). On the other hand they had a cardiac arrest at home more frequently ( P<0.001 ).
Among patients suffering out-of-hospital cardiac arrest in Sweden which was not crew witnessed and in whom resuscitation efforts were attempted, female sex was associated with an increased survival.
评估院外心脏骤停后的生存情况与性别的关系。
纳入1990年至2000年间瑞典心脏骤停登记处登记的所有院外心脏骤停患者，这些患者均尝试进行了心肺复苏（CPR）且非急救人员目击的骤停。该登记处覆盖瑞典85%的居民（约800万居民）。P值针对年龄差异进行了调整。生存定义为心脏骤停后存活并住院以及存活一个月。共有23797名患者参与了调查，其中27.9%为女性。
女性中有16.4%存活并住院，男性为13.2%（P<0.001）。一个月后，女性中有3.0%存活，男性为3.4%（无显著差异）。在一项考虑年龄差异和复苏时各种因素的多变量分析中，女性是存活并住院（比值比1.66；95%置信区间1.49 - 1.84）以及一个月后存活（比值比1.27；95%置信区间1.03 - 1.56）的独立预测因素。女性与男性不同，她们年龄更大（P<0.001），目击心脏骤停的发生率更低（P = 0.01），旁观者进行心肺复苏的发生率更低（P<0.001），初始心律失常为心室颤动的发生率更低（P<0.001），被判定为心脏骤停原因的心脏病发生率更低（P<0.0001）。另一方面，她们在家中发生心脏骤停的频率更高（P<0.001）。
在瑞典未被急救人员目击且尝试进行复苏的院外心脏骤停患者中，女性的生存率更高。
