Awad Emad, Christenson Jim, Grunau Brian, Tallon John, Humphries Karin
Department of Medicine, University of British Columbia, Vancouver, British Columbia, Canada; University of British Columbia, Experimental Medicine, Faculty of Medicine, 2775 Laurel Street, 10th Floor, Room 10117, Vancouver, BC, V5Z 1M9 Canada.
Department of Emergency Medicine, University of British Columbia, Vancouver, British Columbia, Canada; St. Paul's Hospital, Vancouver, British Columbia, Canada; University of British Columbia, Department of Emergency Medicine, Faculty of Medicine, Diamond Health Care Centre 11th floor, 2775 Laurel Street, Vancouver, BC, V5Z 1M9, Canada.
Resuscitation. 2020 Mar 1;148:128-134. doi: 10.1016/j.resuscitation.2020.01.016. Epub 2020 Jan 24.
Out-of-hospital cardiac arrest (OHCA) is common among females and males alike; however, previous studies reported differences in outcomes between sexes in different regions. To investigate possible explanations for this disparity, we examined sex differences in resuscitation interventions in the province of British Columbia (BC).
We performed an observational analysis of the BC Cardiac Arrest Registry (2011-16). We included adults with non-traumatic and EMS-treated OHCA. We examined sex differences in bystander CPR, chest compression rate, and intra-arrest transport using chi-square tests, student's t-test, multivariable linear and logistic regressions.
In total, 7398 patients were eligible for the bystander CPR analysis; 31% were female. More males received bystander CPR (54% vs. 50%); however, male sex was not associated with bystander CPR after adjustment for confounders (adjusted OR male vs. female: 1.07, 95% CI 0.96, 1.18). There was no difference in the chest compression rate for males and females in unadjusted or adjusted analyses. Among subjects who did not achieve prehospital ROSC (n = 5225, 32% females), 64% were pronounced dead at the scene with the remaining transported to hospital. Males more often underwent intra-arrest transport than females (36.7% vs. 34.0%). After adjustment, males had 1.2 greater odds of being transported to hospital than females (95% CI 1.04, 1.37).
We did not detect an association between sex and bystander CPR or chest compression rate. In those who did not achieve prehospital ROSC, males had 1.2-fold greater odds of being transported to hospital compared to females.
院外心脏骤停（OHCA）在男性和女性中都很常见；然而，先前的研究报告了不同地区两性在结局方面存在差异。为了探究这种差异的可能原因，我们研究了不列颠哥伦比亚省（BC）复苏干预措施中的性别差异。
我们对BC心脏骤停登记处（2011 - 16年）进行了观察性分析。纳入了接受非创伤性急救医疗服务治疗的成年OHCA患者。我们使用卡方检验、学生t检验、多变量线性和逻辑回归分析了旁观者心肺复苏（CPR）、胸外按压率和心脏骤停期间转运方面的性别差异。
总共有7398名患者符合旁观者CPR分析的条件；其中31%为女性。接受旁观者CPR的男性更多（54%对50%）；然而，在对混杂因素进行调整后，男性性别与旁观者CPR无关（男性与女性的调整后比值比：1.07，95%置信区间0.96，1.18）。在未调整或调整后的分析中，男性和女性的胸外按压率没有差异。在未实现院前自主循环恢复（ROSC）的受试者中（n = 5225，32%为女性），64%在现场被宣布死亡，其余被送往医院。男性比女性更常接受心脏骤停期间的转运（36.7%对34.0%）。调整后，男性被送往医院的几率比女性高1.2倍（95%置信区间1.04，1.37）。
我们未发现性别与旁观者CPR或胸外按压率之间存在关联。在未实现院前ROSC的患者中，男性被送往医院的几率是女性的1.2倍。
