Cline Sharon L, von Der Lohe Elisabeth, Newman Mary M, Groh William J
Department of Medicine, Krannert Institute of Cardiology, Indiana University, Indianapolis, Indiana, USA.
Heart Rhythm. 2005 May;2(5):492-6. doi: 10.1016/j.hrthm.2005.01.018.
The purpose of this study was to determine whether gender differences exist in the characteristics and outcomes for out-of-hospital cardiac arrest (OHCA) occurring in a rural setting.
In urban settings, women have a lower incidence of OHCA than men but otherwise a comparable survival for ventricular fibrillation (VF) OHCA. Whether OHCA gender differences exist in rural settings is not clear.
The study consisted of a prospective collection and analysis of nontraumatic, adult OHCA prompting a 911 call in six rural Indiana counties.
Over an average period of 2.2 years, 138 women and 250 men experienced OHCA (annual incidence rate: 56.4 per 100,000 men and 29.3 per 100,000 women). Women were older, less likely to experience OHCA in a public setting, more likely to be in an extended care facility, and less likely to have a witnessed arrest than were men. Women were less likely to present with an initial rhythm of VF than men (33.3% vs 53.6%, P < .001). Women in VF had a longer time interval from 911 call to first shock compared with men. Women had poorer survival to hospital discharge for all OHCA (2.2% vs 7.2%, P = .04) and VF OHCA (2.2% vs 13.4%, P = .05) compared with men. After age adjustment, female gender remained associated with a poorer OHCA survival outcome. With adjustment for all significant arrest characteristics, female gender was no longer associated with survival.
In a rural population, women suffering OHCA have a dismal survival rate likely because of multiple unfavorable arrest characteristics.
本研究旨在确定农村地区院外心脏骤停（OHCA）的特征和结局是否存在性别差异。
在城市地区，女性OHCA的发病率低于男性，但室颤（VF）性OHCA的生存率相当。农村地区OHCA是否存在性别差异尚不清楚。
该研究包括对印第安纳州六个农村县因非创伤性成人OHCA拨打911电话的情况进行前瞻性收集和分析。
在平均2.2年的时间里，138名女性和250名男性发生了OHCA（年发病率：男性每10万人中56.4例，女性每10万人中29.3例）。与男性相比，女性年龄更大，在公共场所发生OHCA的可能性更小，更有可能在长期护理机构，且目击心脏骤停的可能性更小。女性初始心律为VF的可能性低于男性（33.3%对53.6%，P<.001）。VF性心脏骤停的女性从拨打911到首次电击的时间间隔比男性更长。与男性相比，所有OHCA（2.2%对7.2%，P=.04）和VF性OHCA（2.2%对13.4%，P=.05）的女性出院生存率更低。年龄调整后，女性性别仍与OHCA较差的生存结局相关。在对所有显著的心脏骤停特征进行调整后，女性性别与生存率不再相关。
在农村人群中，发生OHCA的女性生存率极低，可能是由于多种不利的心脏骤停特征所致。
