院外心脏骤停后生存的性别差异：一项全国性的、基于人群的观察性研究。

Sex-specific differences in survival after out-of-hospital cardiac arrest: a nationwide, population-based observational study.

机构信息

Department of Emergency and Critical Care Medicine, Kanazawa University Hospital, Takaramachi 13-1, Kanazawa, 920-8640, Japan.

Department of Cardiology, Yawata Medical Center, Yawata I 12-7, Komatsu, 923-8551, Japan.

出版信息

Crit Care. 2019 Jul 25;23(1):263. doi: 10.1186/s13054-019-2547-x.

BACKGROUND

It remains unclear whether men have more favorable survival outcomes after out-of-hospital cardiac arrest (OHCA) than women.

METHODS

We reviewed a total of 386,535 patients aged ≥ 18 years with OHCA who were included in the Japanese registry from 2013 to 2016. The study endpoints were the rates of 1-month survival and neurologically intact survival (Cerebral Performance Category Scale score = 1 or 2). Based on age, the reviewed patients were categorized into the following eight groups: < 30, 30-39, 40-49, 50-59, 60-69, 70-79, 80-89, and ≥ 90 years. The survival outcomes in men and women were compared using hierarchical propensity score matching.

RESULTS

The crude survival rate was significantly higher in men than in women in five groups: 30-39, 40-49, 50-59, 60-69, and 70-79 years (all P < 0.001). Similarly, the crude neurologically intact survival rate was significantly higher in men than in women in seven groups: < 30, 30-39, 40-49, 50-59, 60-69, 70-79, and 80-89 years (all P < 0.005). However, multivariate logistic regression analysis of each group revealed no significant sex-specific differences in 1-month survival outcomes (all P > 0.02). Moreover, after hierarchical propensity score matching, the survival outcomes did not significantly differ between both sexes (all P > 0.05).

CONCLUSIONS

No significant sex-specific differences were found in the rates of 1-month survival and neurologically intact survival after OHCA.

背景

目前尚不清楚院外心脏骤停（OHCA）后男性的生存结果是否优于女性。

方法

我们回顾了 2013 年至 2016 年期间纳入日本登记处的总共 386535 名年龄≥18 岁的 OHCA 患者。研究终点为 1 个月生存率和神经功能完整生存率（脑功能预后评分 1 或 2 分）。根据年龄，将回顾性患者分为以下八个组：<30 岁、30-39 岁、40-49 岁、50-59 岁、60-69 岁、70-79 岁、80-89 岁和≥90 岁。使用分层倾向评分匹配比较男性和女性的生存结果。

结果

在五个年龄组（30-39 岁、40-49 岁、50-59 岁、60-69 岁和 70-79 岁）中，男性的粗生存率明显高于女性（均 P<0.001）。同样，在七个年龄组（<30 岁、30-39 岁、40-49 岁、50-59 岁、60-69 岁、70-79 岁和 80-89 岁）中，男性的粗神经功能完整生存率明显高于女性（均 P<0.005）。然而，对每个组的多变量逻辑回归分析显示，1 个月生存率结果无显著性别差异（均 P>0.02）。此外，经过分层倾向评分匹配后，两性之间的生存结果无显著差异（均 P>0.05）。