Department of Emergency Medicine, Dongguk University Ilsan Hospital, Dongguk University College of Medicine, Goyang, Republic of Korea; Laboratory of Emergency Medical Services, Seoul National University Hospital Biomedical Research Institute, Seoul, Republic of Korea.
Laboratory of Emergency Medical Services, Seoul National University Hospital Biomedical Research Institute, Seoul, Republic of Korea; Department of Emergency Medicine, Seoul National University Hospital, Seoul, Republic of Korea; Department of Emergency Medicine, Seoul National University College of Medicine, Seoul, Republic of Korea.
Resuscitation. 2023 Jun;187:109797. doi: 10.1016/j.resuscitation.2023.109797. Epub 2023 Apr 18.
Bystander cardiopulmonary resuscitation (CPR) is a critical factor in improving out-of-hospital cardiac arrest (OHCA) survival. The aim of this study was to investigate the interaction effect of bystander sex and patient sex on the provision of bystander CPR.
This was a retrospective cohort study using national OHCA registry in Korea. The inclusion criteria were adult bystander-witnessed OHCA patients with presumed cardiac etiology from January 2016 to December 2020. The primary outcome was the provision of bystander CPR. Multivariable logistic regression and interaction analysis were conducted to evaluate the impact of bystander sex on bystander CPR provision based on patient sex.
The study included 24,919 patients with OHCA, 58.2% with male-bystanders and 41.8% with female-bystanders. Female bystanders were less likely to perform bystander CPR than male bystanders (68.0% vs. 78.8%, adjusted OR (95% CI): 0.62 (0.58-0.66)). Among patients with CPR-trained bystanders, female bystanders had lower odds of bystander CPR (0.85 (0.73-0.97)). In the interaction analysis between bystander and patient sex, a significant difference was observed in the likelihood of bystander CPR according to the patient sex. Female bystanders had lower odds of bystander CPR than male bystanders for male patients (0.47 (0.43-0.50)). However, there were no significant differences between male and female bystanders for female patients (0.91 (0.88-1.07)).
Female bystanders have a lower likelihood of providing bystander CPR than male bystanders. Additionally, an interaction was observed between bystander sex and patient sex in the providing bystander CPR, with the association being more pronounced in male OHCA patients.
旁观者心肺复苏（CPR）是提高院外心脏骤停（OHCA）存活率的关键因素。本研究旨在探讨旁观者性别与患者性别对旁观者 CPR 实施的交互作用。
这是一项使用韩国全国 OHCA 登记处的回顾性队列研究。纳入标准为 2016 年 1 月至 2020 年 12 月期间有旁观者目击的、推测为心源性 OHCA 成年患者。主要结局是旁观者 CPR 的实施。采用多变量逻辑回归和交互分析，根据患者性别评估旁观者性别的作用对旁观者 CPR 实施的影响。
本研究共纳入 24919 例 OHCA 患者，其中 58.2%为男性旁观者，41.8%为女性旁观者。女性旁观者实施旁观者 CPR 的可能性低于男性旁观者（68.0%比 78.8%，调整后的 OR（95%CI）：0.62（0.58-0.66））。在有受过 CPR 培训的旁观者中，女性旁观者实施旁观者 CPR 的可能性较低（0.85（0.73-0.97））。在旁观者和患者性别的交互分析中，根据患者性别，旁观者 CPR 的可能性存在显著差异。对于男性患者，女性旁观者实施旁观者 CPR 的可能性低于男性旁观者（0.47（0.43-0.50））。然而，对于女性患者，男女旁观者之间没有显著差异（0.91（0.88-1.07））。
女性旁观者实施旁观者 CPR 的可能性低于男性旁观者。此外，旁观者性别与患者性别在提供旁观者 CPR 方面存在交互作用，这种关联在男性 OHCA 患者中更为明显。
