Mandigers Loes, Termorshuizen Fabian, de Keizer Nicolette F, Rietdijk Wim, Gommers Diederik, Dos Reis Miranda Dinis, den Uil Corstiaan A
Department of Intensive Care, Erasmus University Medical Center, Rotterdam, the Netherlands.
National Intensive Care Evaluation (NICE) foundation, Amsterdam, the Netherlands; Department of Medical Informatics, Amsterdam UMC, Amsterdam Public Health Research Institute, University of Amsterdam, Amsterdam, the Netherlands.
J Crit Care. 2021 Aug;64:176-183. doi: 10.1016/j.jcrc.2021.04.007. Epub 2021 Apr 17.
We study sex differences in 1-year mortality of out-of-hospital cardiac arrest (OHCA) and in-hospital cardiac arrest (IHCA) patients admitted to the intensive care unit (ICU).
A retrospective cohort analysis of OHCA and IHCA patients registered in the NICE registry in the Netherlands. The primary and secondary outcomes were 1-year and hospital mortality, respectively.
We included 19,440 OHCA patients (5977 women, 30.7%) and 13,461 IHCA patients (4889 women, 36.3%). For OHCA, 1-year mortality was 63.9% in women and 52.6% in men (Hazard Ratio [HR] 1.28, 95% Confidence Interval [95% CI] 1.23-1.34). For IHCA, 1-year mortality was 60.0% in women and 57.0% in men (HR 1.09, 95% CI 1.04-1.14). In OHCA, hospital mortality was 57.4% in women and 46.5% in men (Odds Ratio [OR] 1.42, 95% CI 1.33-1.52). In IHCA, hospital mortality was 52.0% in women and 48.2% in men (OR 1.11, 95% CI 1.03-1.20).
Women admitted to the ICU after cardiac arrest have a higher mortality rate than men. After left-truncation, we found that this sex difference persisted for OHCA. For IHCA we found that the effect of sex was mainly present in the initial phase after the cardiac arrest.
我们研究了入住重症监护病房（ICU）的院外心脏骤停（OHCA）和院内心脏骤停（IHCA）患者1年死亡率的性别差异。
对荷兰NICE登记处登记的OHCA和IHCA患者进行回顾性队列分析。主要和次要结局分别为1年死亡率和医院死亡率。
我们纳入了19440例OHCA患者（5977例女性，占30.7%）和13461例IHCA患者（4889例女性，占36.3%）。对于OHCA，女性1年死亡率为63.9%，男性为52.6%（风险比[HR]为1.28，95%置信区间[95%CI]为1.23 - 1.34）。对于IHCA，女性1年死亡率为60.0%，男性为57.0%（HR为1.09，95%CI为1.04 - 1.14）。在OHCA中，女性医院死亡率为57.4%，男性为46.5%（优势比[OR]为1.42，95%CI为1.33 - 1.52）。在IHCA中，女性医院死亡率为52.0%，男性为48.2%（OR为1.11，95%CI为1.03 - 1.20）。
心脏骤停后入住ICU的女性死亡率高于男性。在剔除左删失数据后，我们发现这种性别差异在OHCA中持续存在。对于IHCA，我们发现性别影响主要出现在心脏骤停后的初始阶段。
