性别差异在儿科院外心脏骤停中接受非专业心肺复苏术的表现:日本全国队列研究。

Sex Differences in Receiving Layperson Cardiopulmonary Resuscitation in Pediatric Out-of-Hospital Cardiac Arrest: A Nationwide Cohort Study in Japan.

机构信息

1 Department of Emergency Medicine University of Pittsburgh School of Medicine Pittsburgh PA.

2 Department of Emergency Medicine Kyoto Prefectural University of Medicine Kyoto Japan.

出版信息

J Am Heart Assoc. 2019 Jan 8;8(1):e010324. doi: 10.1161/JAHA.118.010324.

Abstract

Background Layperson cardiopulmonary resuscitation ( CPR ) is a crucial intervention for patients with out-of-hospital cardiac arrest ( OHCA ). Although a sex disparity in receiving layperson CPR (ie, female patients were less likely to receive layperson CPR ) has been reported in adults, there are few data in the pediatric population, and we therefore investigated sex differences in receiving layperson CPR in pediatric patients with OHCA . Methods and Results From the All-Japan Utstein Registry, a prospective, nationwide, population-based OHCA database, we included pediatric patients (≤17 years) with layperson-witnessed OHCA from 2005 through 2015. The primary outcome was receiving layperson CPR . Patient sex was the main exposure. We fitted multivariable logistic regression models to examine associations between patient sex and receiving layperson CPR . We included a total of 4525 pediatric patients with layperson-witnessed OHCA in this study, 1669 (36.9%) of whom were female. Female patients received layperson CPR more often than male patients (831/1669 [49.8%] versus 1336/2856 [46.8%], P=0.05). After adjustment for age, time of day of arrest, year, witnesses persons, and dispatcher CPR instruction, the sex difference in receiving layperson CPR was not significant (adjusted odds ratio for female subjects 1.14, 95% CI, 0.996-1.31). Conclusions In a pediatric population, female patients with layperson-witnessed OHCA received layperson CPR more often than male patients. After adjustment for covariates, there was no significant association between patient sex and receiving layperson CPR .

摘要

背景 非专业人员心肺复苏(CPR)是院外心脏骤停(OHCA)患者的重要干预措施。尽管成年人中已经报道了接受非专业人员 CPR 的性别差异(即女性患者接受非专业人员 CPR 的可能性较小),但在儿科人群中数据很少,因此我们调查了 OHCA 儿科患者接受非专业人员 CPR 的性别差异。

方法和结果 从日本全国家庭 Utstein 注册处(一个前瞻性的、全国性的、基于人群的 OHCA 数据库)中,我们纳入了 2005 年至 2015 年期间有非专业人员目击的 OHCA 的儿科患者(≤17 岁)。主要结局是接受非专业人员 CPR。患者性别是主要暴露因素。我们拟合了多变量逻辑回归模型,以检验患者性别与接受非专业人员 CPR 之间的关联。我们共纳入了 4525 名有非专业人员目击的 OHCA 的儿科患者,其中 1669 名(36.9%)为女性。女性患者接受非专业人员 CPR 的比例高于男性患者(831/1669 [49.8%]比 1336/2856 [46.8%],P=0.05)。在校正年龄、发病时间、年份、目击者和调度员 CPR 指导后,接受非专业人员 CPR 的性别差异不显著(女性患者的调整优势比为 1.14,95%CI,0.996-1.31)。

结论 在儿科人群中,有非专业人员目击的 OHCA 的女性患者比男性患者更常接受非专业人员 CPR。在校正混杂因素后,患者性别与接受非专业人员 CPR 之间没有显著关联。

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