Centre for Research and Evaluation, Ambulance Victoria, Doncaster, Victoria, Australia; Department of Epidemiology and Preventive Medicine, Monash University, Prahran, Victoria, Australia; Department of Community Emergency Health and Paramedic Practice, Monash University, Frankston, Victoria, Australia.
Centre for Research and Evaluation, Ambulance Victoria, Doncaster, Victoria, Australia; Department of Epidemiology and Preventive Medicine, Monash University, Prahran, Victoria, Australia.
Resuscitation. 2019 Apr;137:21-28. doi: 10.1016/j.resuscitation.2019.01.034. Epub 2019 Feb 5.
Although survival from out-of-hospital cardiac arrest (OHCA) is improving, little is known about the long-term outcome of survivors. In this study, we assess the impact of sex on 12 month functional recovery and health-related quality-of-life (HRQoL) outcomes in OHCA survivors.
Between 2010 and 2016, consecutive adult OHCA survivors were invited to participate in structured telephone interviews using the Glasgow Outcome Scale-Extended (GOSE), the EuroQol-5D (EQ-5D), and 12-Item Short Form (SF-12) health survey.
Of the 2300 patients discharged alive, 175 (7.6%) died during the follow-up period with the rate of death at 12 months being higher in women compared to men (10.4% vs. 6.4%; p = 0.002). Of the 2125 12 month survivors, 1752 (82.5%) participated in the interviews. Unadjusted outcomes were consistently poorer for females compared to males, with fewer women reporting good functional recovery (GOSE ≥ 7, 53.5% vs. 64.8%, p < 0.001) and living at home without care (60.7% vs. 76.4%, p < 0.001). After adjustment, female sex reduced the odds of good functional recovery (adjusted odds ratio [AOR] 0.69, 95% CI: 0.53-0.88; p = 0.004), living at home without care (AOR 0.57, 95% CI: 0.43-0.76; p < 0.001), an EQ-5D index score of 1 (AOR 0.57, 95% CI: 0.43-0.75; p < 0.001), an SF-12 mental component summary ≥50 (AOR 0.56, 95% CI: 0.40-0.78; p = 0.001) and an SF-12 physical component summary ≥50 (AOR 0.53, 95% CI: 0.39-0.71; p < 0.001).
Women report poorer functional recovery and HRQoL after OHCA. Further research is needed to better understand the reasons for these disparities.
尽管院外心脏骤停（OHCA）患者的生存率有所提高，但对于幸存者的长期预后知之甚少。本研究旨在评估性别对 OHCA 幸存者 12 个月时功能恢复和健康相关生活质量（HRQoL）结局的影响。
在 2010 年至 2016 年间，连续邀请成年 OHCA 幸存者接受结构电话访谈，使用格拉斯哥结局量表扩展版（GOSE）、欧洲五维健康量表（EQ-5D）和 12 项简明健康调查（SF-12）。
在 2300 名出院存活的患者中，175 名（7.6%）在随访期间死亡，女性 12 个月时的死亡率高于男性（10.4%比 6.4%；p=0.002）。在 2125 名 12 个月幸存者中，1752 名（82.5%）接受了访谈。女性的未调整结局始终比男性差，较少的女性报告功能恢复良好（GOSE≥7，53.5%比 64.8%，p<0.001）和无需护理即可居家生活（60.7%比 76.4%，p<0.001）。调整后，女性性别降低了功能恢复良好的可能性（调整后的优势比[OR]0.69，95%置信区间：0.53-0.88；p=0.004），无需护理即可居家生活（OR 0.57，95% CI：0.43-0.76；p<0.001），EQ-5D 指数评分为 1（OR 0.57，95% CI：0.43-0.75；p<0.001），SF-12 心理成分综合评分为≥50（OR 0.56，95% CI：0.40-0.78；p=0.001）和 SF-12 生理成分综合评分为≥50（OR 0.53，95% CI：0.39-0.71；p<0.001）。
女性在 OHCA 后报告功能恢复和 HRQoL 较差。需要进一步研究以更好地了解这些差异的原因。
