Wissenberg Mads, Hansen Carolina Malta, Folke Fredrik, Lippert Freddy K, Weeke Peter, Karlsson Lena, Rajan Shahzleen, Søndergaard Kathrine Bach, Kragholm Kristian, Christensen Erika Frischknecht, Nielsen Søren L, Køber Lars, Gislason Gunnar H, Torp-Pedersen Christian
Department of Cardiology, Copenhagen University Hospital Gentofte, Niels Andersens Vej 65, 2900 Hellerup, Denmark.
Department of Cardiology, Copenhagen University Hospital Gentofte, Niels Andersens Vej 65, 2900 Hellerup, Denmark.
Resuscitation. 2014 Sep;85(9):1212-8. doi: 10.1016/j.resuscitation.2014.06.008. Epub 2014 Jun 21.
Crude survival has increased following an out-of-hospital cardiac arrest (OHCA). We aimed to study sex-related differences in patient characteristics and survival during a 10-year study period.
Patients≥12 years old with OHCA of a presumed cardiac cause, and in whom resuscitation was attempted, were identified through the Danish Cardiac Arrest Registry 2001-2010. A total of 19,372 patients were included.
One-third were female, with a median age of 75 years (IQR 65-83). Compared to females, males were five years younger; and less likely to have severe comorbidities, e.g., chronic obstructive pulmonary disease (12.8% vs. 16.5%); but more likely to have arrest outside of the home (29.4% vs. 18.7%), receive bystander CPR (32.9% vs. 25.9%), and have a shockable rhythm (32.6% vs. 17.2%), all p<0.001. Thirty-day crude survival increased in males (3.0% in 2001 to 12.9% in 2010); and in females (4.8% in 2001 to 6.7% in 2010), p<0.001. Multivariable logistic regression analyses adjusted for patient characteristics including comorbidities, showed no survival difference between sexes in patients with a non-shockable rhythm (OR 1.00; CI 0.72-1.40), while female sex was positively associated with survival in patients with a shockable rhythm (OR 1.31; CI 1.07-1.59). Analyses were rhythm-stratified due to interaction between sex and heart rhythm; there was no interaction between sex and calendar-year.
Temporal increase in crude survival was more marked in males due to poorer prognostic characteristics in females with a lower proportion of shockable rhythm. In an adjusted model, female sex was positively associated with survival in patients with a shockable rhythm.
院外心脏骤停（OHCA）后的粗生存率有所提高。我们旨在研究10年研究期间患者特征和生存情况的性别差异。
通过丹麦心脏骤停登记处识别出年龄≥12岁、疑似心脏原因导致OHCA且尝试进行复苏的患者。2001年至2010年共纳入19372例患者。
三分之一为女性，中位年龄75岁（四分位间距65 - 83岁）。与女性相比，男性年轻5岁；患严重合并症的可能性较小，如慢性阻塞性肺疾病（12.8%对16.5%）；但在家外发生心脏骤停的可能性更大（29.4%对18.7%），接受旁观者心肺复苏的可能性更大（32.9%对25.9%），且出现可除颤心律的可能性更大（32.6%对17.2%），所有p<0.001。男性的30天粗生存率有所提高（从2001年的3.0%提高到2010年的12.9%）；女性也有所提高（从2001年的4.8%提高到2010年的6.7%），p<0.001。对包括合并症在内的患者特征进行调整的多变量逻辑回归分析显示，非可除颤心律患者的性别间生存率无差异（比值比1.00；可信区间0.72 - 1.40），而女性性别与可除颤心律患者的生存呈正相关（比值比1.31；可信区间1.07 - 1.59）。由于性别与心律之间存在相互作用，分析按心律分层；性别与日历年之间无相互作用。
由于女性预后特征较差，可除颤心律比例较低，男性的粗生存率随时间的增加更为明显。在调整模型中，女性性别与可除颤心律患者的生存呈正相关。
